Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deutschen Plastischen Chirurgen
-
Handchir Mikrochir Plast Chir · Apr 2007
Review Comparative Study[Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review].
Medical leech therapy has enjoyed a renaissance in the world of reconstructive microsurgery during recent years. Especially venous congestion is decreased using hirudo medicinalis application such as following replantation of amputated fingers or congested flaps. They provide a temporary relief to venous engorgement whilst venous drainage is re-established. ⋯ Infection associated with leech therapy is a documented complication of leech application, with reported incidences ranging from 2.4 to 20 % and a chinolone antibiotic is currently recommended to face the potential Aeromonas hydrophila infection. Anemia is a second adverse effect during medicinal leech application which has to be taken account with repetitive blood samples. Besides the successful applications of leeches in various applications in plastic and reconstructive microsurgery, randomized-controlled trials are pending to elucidate the value of hirudo medicinalis according to evidence-based criteria above from case series and case studies.
-
Septic arthritis of finger joints is rare and its management not standardized. The outcome of all consecutive patients with finger joint arthritis was analyzed in terms of risk factors, surgical technique, antimicrobial therapy and hand therapy. ⋯ Septic arthritis of finger joints should be early recognized and immediately treated with surgery and antibiotics, in order to avoid cartilage damage. If cartilage is already damaged, primary arthrodesis with the use of an external fixation is indicated.