Amputação Traumática do Braço: Critérios de Reimplantação

• Autor(a) principal: Ana Francisca da Costa Lemos da Rocha Montenegro
• Data de Publicação: 2021
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://hdl.handle.net/10216/134349
• topic: Medicina clínica; Clinical medicine

Introduction: The advances in microsurgical techniques and instruments adopted in post-traumatic arm replantation have allowed progressively higher success rates. Arm replantation is associated with a higher risk of complications, including death, when compared to distal replantation. In addition, it is usually not possible to accurately predict the survival of the replantation. This literature review aims to gather the most commonly used indications and the factors to consider in the decision to replant the arm. Materials and Methods: A research of the articles published in the Medline (PubMed), ResearchGate and GoogleScholar databases was carried out regarding the criteria for replantation after traumatic amputation at the level of the arm, between 2014 and 2021. 45 articles were included, 2 of which were prior to 2014 due to their relevance to the topic. Results/Discussion: Indications for replantation include stable patients, sharp injury mechanism, warm ischemia time of less than 6-8 hours, cold ischemia time of less than 12 hours and absence of comorbidities or serious concomitant injuries. In children, these indications are usually broader. As contraindications, unstable or polytrauma patients, severe crush or avulsion injuries, warm ischemia time over 6-8 hours or cold ischemia time over 12 hours and absence of surgical conditions should be considered. In addition, scoring systems should not be used in isolation in this decision. Conclusion: The decision between replantation versus definitive amputation must be made on a case-by-case basis by a multidisciplinary team, always taking the patient's objectives and will into account.