Groin Flap Immobilization by Axillary Brachial Plexus Block Anesthesia

Bekler, Halil; Beyzadeoğlu, Tahsin; Mercan, Arzu

doi:10.1097/bth.0b013e3181590791

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…The risk of infarction is close to none as long as the hand and fingers post-debridement is viable with capillary refill times of less than two seconds [ 4 , 5 ]. In other centers, axillary brachial plexus blocks are given combined with general anaesthesia to ensure a secure hand positioning post-operatively [ 6 ] but we demonstrated that is this possible with just WALANT.…”

Section: Introductionmentioning

confidence: 82%

Coverage of a Firecracker Blast Injury of the Right Hand With a Chest Wall Flap Under Wide Awake Local Anaesthesia no Tourniquet Technique

Alexander

Abdullah

Singh

et al. 2021

Cureus

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A flap is done to cover expose structures such as bone, tendon and ligament. Chest wall flaps are usually performed under general anaesthesia due to a fairly large area of surgery and at two different sites which are the chest and the hand. This is the first known reported case of a chest wall flap for coverage of the hand under Wide awake local anaesthesia no tourniquet technique (WALANT). We here report the case of a 32-year-old man who had a firecracker injury over his right hand with bone exposed in his right index and middle finger and distal amputation of the thumb with first carpometacarpal joint dislocation. Chest wall flap reconstruction for coverage of a severe blast injury in the hand is possible and safe under WALANT. The proper technique and administration will lead to a successful surgery without general anesthesia complications and risks. This alternative option may be useful in districts or smaller hospitals where resources are limited.

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Section: Introductionmentioning

confidence: 82%

Coverage of a Firecracker Blast Injury of the Right Hand With a Chest Wall Flap Under Wide Awake Local Anaesthesia no Tourniquet Technique

Alexander

Abdullah

Singh

et al. 2021

Cureus

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“…Harvesting of distant pedicled flaps for bilateral hand reconstruction can be done under brachial plexus and subarachonid block; which avoids complications and costs derived from general anaesthesia, as well as complications of an sudden awakening of the patient, who with his or her movements can shear the recently inset flap [23] .…”

Section: Discussionmentioning

confidence: 99%

The use of pedicled abdominal flaps for coverage of acute bilateral circumferential degloving injuries of the hand

Sabapathy

Venkatramani

Playa

2015

Trauma Case Reports

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Reconstruction of bilateral soft tissue defects in hand and distal third of the forearm, is a challenge for any reconstructive surgeon. When there is circumferential skin loss affecting the whole hand and fingers as in major degloving injuries, the extent of tissue required for reconstruction narrows down the choice of flaps. When the injury affects both hands the magnitude of the problem becomes compounded. There is no report in the literature of free skin flaps to cover circumferential degloving injuries in both hands. We are presenting the technical considerations and outcome of pedicled abdominal flaps used for immediate coverage of circumferential degloving injuries of both hands.

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“…The next complication with the flap is that the patient has to have the hand in the groin for a prolonged period while it is relatively immobile. This can be performed with techniques such as ace wraps, plaster, external fixators, or under axillary block 21. These techniques are not without their own complications.…”

Section: Discussionmentioning

confidence: 99%

Multiple toe transfer and sensory free flap use after a traumatic amputation of multiple digits. Surgery done in a single setting: A case study

Galpern

Tsai

2011

Microsurgery

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Crush avulsion injuries to the hand with concomitant traumatic amputation of multiple digits can be a devastating injury to the patient. These injuries have multiple issues occurring under emergency conditions. When feasible, replantation of the multiple digits is optimal, but in many cases, it is not possible. Because of the crushing force on the digits, they are not viable candidates for replantation. The usual course of treatment for these patients is a two stage procedure, usually involving a groin flap. Here, we present the case of a patient who had a left hand skin avulsion of the whole palm and P1 of index, long, ring and small fingers. The left index finger had a complete amputation at the P2 level, the long, ring and small fingers all had complete amputations at the P1 level. This injury was dealt with by a left foot second and third toe transplant, a sensory free flap from the left big toe and a fourth toe microvascular free transfer to the left hand. The remainder of the defect was managed with a 10 × 14 cm reversed radial forearm flap and a combination of full and split thickness skin grafts. The procedure was performed in a single operation, obviating the need for a second surgery. This procedure optimized the patient's outcome during a single setting, making it an ideal choice in an emergency setting.

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Groin Flap Immobilization by Axillary Brachial Plexus Block Anesthesia

Cited by 4 publications

References 14 publications

Coverage of a Firecracker Blast Injury of the Right Hand With a Chest Wall Flap Under Wide Awake Local Anaesthesia no Tourniquet Technique

Coverage of a Firecracker Blast Injury of the Right Hand With a Chest Wall Flap Under Wide Awake Local Anaesthesia no Tourniquet Technique

The use of pedicled abdominal flaps for coverage of acute bilateral circumferential degloving injuries of the hand

Multiple toe transfer and sensory free flap use after a traumatic amputation of multiple digits. Surgery done in a single setting: A case study

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