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Does the type of anesthesia administered affect the efficacy of medicinal leech therapy after finger replantation: clinical observations in a 6‐year‐old boy
Author(s) -
Orkic Zelimir,
Mraovic Boris,
Kvolik Slavica,
Istvanic Tomislav,
Divkovic Dalibor,
Kristek Jozo
Publication year - 2012
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2012.03866.x
Subject(s) - medicine , replantation , anesthesia , leech , airway , affect (linguistics) , surgery , linguistics , philosophy , computer science , world wide web
We are present adjuvant management after a complete degloving injury and fingers replantation in a 6 year old child. The child suffered a third and ring finger avulsion injury. Fracture stabilization with Kirschner wires in proximal interphalangeal joint of each finger and reconstruction of ligaments was followed by microsurgical repair with one artery reconstruction. On the postoperative day 2, bleeding at the replantation line decreased. Both fingers had signs of venous congestion and were cyanotic. Medicinal leeches migrated from cyanotic tissue. After hyperoxygenation during propofol anesthesia replanted fingers regained normal color and leeches and attached firmly. Oxygen therapy was continued with CPAP once a day until four weeks after trauma through a noninvasive face mask. Subsequently tissue cultures revealed Pseudomonas putida strain which was treated with antibiotics. The child was discharged home with a good outcome.