Donor transplant fingers
Donor transplant fingers do not usually have anything to do with the bodies taken from other people. This is quite understandable. Despite modern medical advances, transplantation of any organ or tissue from other people always carries a high risk of rejection. That's why doctors are forced to spend immunosuppressive therapy that suppresses their own immune system, which also adds health patients. The very selection of organs and tissues from other donors is very lengthy, thorough and time-consuming, because to achieve the selection of patients who will be most compatible tissue. Fortunately, the transplant donor fingers usually does not require the expertise to find donors.
In most cases, uses its own organs and tissues. This donor tissue is called autograft. The fact that the area of the palmar surface of the brush is only 1% of the total area of human skin. This knowledge is used to determine the area of skin lesions with the palm of your hand (eg, burns). This means that if the donor transplant requires finger flaps of skin area is less than 1%.
Donor site can be a separate part of the skin, and a finger. Consequently, we can distinguish two fundamentally different approaches to transplant fingers:
- reconstruction of the fingers through the skin (or skin-bone) grafts
- donor transplants using microsurgical finger technique.
Reconstruction of the fingers using skin flaps. This recovery method is used in the finger when the finger bone base does not significantly damaged and missing only a skin flap, which is taken usually from neighboring areas. For example, a donor of the first finger can be second or third finger for the second – the third for the third – the second or fourth, etc.
Usually, the skin is transplanted to the subcutaneous fat and fascia. They cut out from the side, rear, side or rear surface of the donor finger if necessary. For example, if significantly damaged index finger pad, the donor site is usually the rear surface of the middle phalanx of the third finger.
What to do with skin defect formed on the adjacent finger? For him, taking a skin flap from another part of the body where it can easily pull up and sew without compromising aesthetics and function. Usually used for this purpose the inner surface of the shoulder or upper arm. Direct transfer from the shoulder is not suitable because the skin flap from an adjacent finger is not cut out all at once, but only an incision around the circle so that one side of it remained intact and continued to eat from one of the vessels. In this case, healing is faster and less painfully.
In the event of damage to the nail phalanx often use skin from the palmar surface of the same hand. Semicircular incision is made and the finger, which requires the restoration of this site is stitched to the skin on the palms. After implantation and germination of their own vessels in the thickness of the transplanted tissue, meets the rest of the skin, and finally formed shape of the finger. This usually takes about three weeks.
If the patient does not want to part with his fingers on his leg, and a significant defect of thumb, we have to resort to other methods, such as the formation of a finger with skin and bone flap on the forearm vascular pedicle.
In the event of a significant loss of tissue transplants using donor of all or part of a finger. Most often used for this purpose toes. To restore the length, shape and functionality of transplanted toe or part of it is the best solution, because it does not require significant effort to create the appearance of the finger. However, some patients may refrain from microsurgical transplantation of toes, because of fear of violation of the appearance or function of the lower limb after transplantation.
Fortunately, years of experience in similar transplants show marked advantages of the method on a background of minimal drawbacks:
- High aesthetic restoration of the lost finger. The absence of a finger on the hand very much, and transplantation of thumb is completely restore its structure. The similarity of the structure of the fingers and toes can make the most natural form of the hand.
- Restoring the lost function. The fact that not only restored the structure and basic functions. Through the use of microsurgical technique restores the sensitivity of the fingers, allowing most patients to fully return to a familiar work.
- The absence of significant changes in the structure and function of the foot. Loss of one finger (usually the latter) is not evident and not immediately visible on the leg. Given that the toes are rarely attract attention, or being exposed, the operation becomes even less significant in terms of aesthetics. It is important that a missing finger is not a gaping: the third finger as close to the first and this defect is even less noticeable.
There are other options for plastic fingers through donor sites of his own body. Type of operation is determined in each case individually, and is consistent with the patient.
Center of Traumatology and ORTHOPAEDICS – Hospital FCS – MOSCOW
Treatment and rehabilitation center for Health Care – Moscow
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REHABILITATION IN ISRAEL – Levinstein rehabilitation center
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- thumb transplant from donor
- Transplant finger and thumb