亚甲蓝与双氧水混合液在手指钝性离断伤微创再植术中的应用

Application of methylene blue and hydrogen peroxide mixture in minimally invasive replantation of blunt severed fingers

目的探讨亚甲蓝与双氧水混合液在手指钝性离断伤微创再植手术中的应用价值。方法2014年7月-2020年12月收治单一手指钝性完全离断伤再植手术患者52例,使用亚甲蓝与双氧水混合液湿敷断指创面,其坏死组织立即被蓝染,在显微镜下精准清创坏死组织,缩短手术时间。结果全组患指术后均获1~6个月随访,掌握患指感觉、手指屈伸功能恢复情况。两点辨别觉参照英国医学会制定的标准,术后感觉恢复为:优35例,良14例,可3例;总体满意度为94.2%。术后6个月手指关节活动度,参照TAM标准评定:优30例,良18例,可4例;手指关节活动度恢复总体优良率为92.3%。尚未发现(或发生)亚甲蓝不良反应等情况。结论亚甲蓝与双氧水混合液在手指钝性离断伤微创再植手术中具有创面染色快捷、高效、安全可靠的作用,有利于精准清创,可缩短手术时间,减少医源性损伤,有利于断指成活和手功能的满意恢复,值得在断指再植手术中推广应用。

Objective To explore the application value of methylene blue and hydrogen peroxide mixture in minimally invasive replantation of blunt severed fingers.Methods From July 2014 to December 2020,52 patients with blunt complete amputation and replantation of a single finger were treated in our hospital.We used the mixture of methylene blue and hydrogen peroxide to compress the severed finger wound,the necrotic tissue was immediately blue stained,and the necrotic tissue was accurately debridemented under the microscope.At the same time,it could shorten the operation time,reduce iatrogenic injury,and realize the minimally invasive treatment in the replantation of severed fingers.Results The patients were followed up from 1 to 6 months after operation to understand the recovery of finger sensation and finger flexion and extension function.According to the standards formulated by the British Medical Association,the postoperative sensory recovery of patients in this group was excellent in 35 cases,good in 14 cases and fair in 3 cases;The overall satisfaction was 94.2%.Six months after operation,according to the TAM standard,the patients in this group were excellent in 30 cases,good in 18 cases and fair in 4 cases;The overall excellent and good rate of finger joint range of motion recovery was 92.3%.No adverse reactions of methylene blue had been found(or occurred).Conclusion The mixture of methylene blue and hydrogen peroxide played a fast,efficient,safe and reliable role in wound dyeing in the minimally invasive replantation of blunt severed fingers.It was conducive to accurate debridement,shorten the operation time,reduce iatrogenic injury,realize the minimally invasive treatment in the replantation of the survival of severed fingers and the satisfactory recovery of hand funtion.It was worthy of popularization and application in the replantation of severed fingers.