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Rönkkö H, Neergård Sletten I, Liv Hansen K, Ryhänen J, Pietreanu M, Jokihaara J. Indications, anaesthesia and postoperative protocol for replantation and revascularization in the hand in Nordic countries. J Hand Surg Eur Vol 2023; 48:46-51. [PMID: 36165410 PMCID: PMC9773149 DOI: 10.1177/17531934221123427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In this survey, we compared the current postoperative practices in the largest replantation units of four Nordic countries. The topics included were indication for surgery, anaesthesia, postoperative monitoring, use of antibiotics, anticoagulation and postoperative intravenous fluids, change of dressings, duration of bed rest and hospital stay, hand therapy and follow-up after discharge. Although there were many similarities between the units in the postoperative protocols, we found a large variety of practices. There is no robust evidence to assess or support or reject most of the strategies in postoperative care. The differences in practice warrant prospective studies in order to establish an evidence-based postoperative protocol for replantation surgery.
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Affiliation(s)
- Henrikki Rönkkö
- Department of Musculoskeletal Diseases, Tampere University Hospital, Tampere, Finland
| | | | - Karina Liv Hansen
- Department of Hand and Microsurgery, Odense University Hospital, Odense, Denmark
| | - Jorma Ryhänen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mihai Pietreanu
- Department of Hand Surgery, Stockholm University Hospital, Stockholm, Sweden
| | - Jarkko Jokihaara
- Department of Musculoskeletal Diseases, Tampere University Hospital, Tampere, Finland,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland,Jarkko Jokihaara, Department of Musculoskeletal Diseases, Tampere University Hospital, Kuntokatu 2, 33520 Tampere, Finland.
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Lu C, Prahm C, Chen Y, Ehnert S, Rinderknecht H, McCaig CD, Nussler AK, Kolbenschlag J. Microcurrent Reverses Cigarette Smoke-Induced Angiogenesis Impairment in Human Keratinocytes In Vitro. Bioengineering (Basel) 2022; 9:bioengineering9090445. [PMID: 36134990 PMCID: PMC9495747 DOI: 10.3390/bioengineering9090445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 11/23/2022] Open
Abstract
Cigarette smoking (CS) leads to several adverse health effects, including diseases, disabilities, and even death. Post-operative and trauma patients who smoke have an increased risk for complications, such as delayed bone or wound healing. In clinical trials, microcurrent (MC) has been shown to be a safe, non-invasive, and effective way to accelerate wound healing. Our study aimed to investigate if MC with the strength of 100 μA may be beneficial in treating CS-related healing impairment, especially in regard to angiogenesis. In this study, we investigated the effect of human keratinocyte cells (HaCaT) on angiogenesis after 72 h of cigarette smoke extract (CSE) exposure in the presence or absence of 100 μA MC. Cell viability and proliferation were evaluated by resazurin conversion, Sulforhodamine B, and Calcein-AM/Hoechst 33342 staining; the pro-angiogenic potential of HaCaT cells was evaluated by tube formation assay and angiogenesis array assay; signaling pathway alterations were investigated using Western blot. Constant exposure for 72 h to a 100 μA MC enhanced the angiogenic ability of HaCaT cells, which was mediated through the PI3K-Akt signaling pathway. In conclusion, the current data indicate that 100 μA MC may support wound healing in smoking patients by enhancing angiogenesis.
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Affiliation(s)
- Chao Lu
- Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Klinik Tuebingen, University of Tuebingen, Schnarrenbergstrasse 95, D-72076 Tuebingen, Germany
| | - Cosima Prahm
- Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Klinik Tuebingen, University of Tuebingen, Schnarrenbergstrasse 95, D-72076 Tuebingen, Germany
| | - Yangmengfan Chen
- Siegfried-Weller Institute for Trauma Research, BG Kinik Tuebingen, University of Tuebingen, Schnarrenbergstrasse 95, D-72070 Tuebingen, Germany
| | - Sabrina Ehnert
- Siegfried-Weller Institute for Trauma Research, BG Kinik Tuebingen, University of Tuebingen, Schnarrenbergstrasse 95, D-72070 Tuebingen, Germany
| | - Helen Rinderknecht
- Siegfried-Weller Institute for Trauma Research, BG Kinik Tuebingen, University of Tuebingen, Schnarrenbergstrasse 95, D-72070 Tuebingen, Germany
| | - Colin D. McCaig
- Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK
| | - Andreas K. Nussler
- Siegfried-Weller Institute for Trauma Research, BG Kinik Tuebingen, University of Tuebingen, Schnarrenbergstrasse 95, D-72070 Tuebingen, Germany
- Correspondence: ; Tel.: +49-7071-606-1065
| | - Jonas Kolbenschlag
- Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Klinik Tuebingen, University of Tuebingen, Schnarrenbergstrasse 95, D-72076 Tuebingen, Germany
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