EARLY PREVENTION OF MICROVASCULAR ANASTOMOSIS THROMBOSES IN PATIENTS WITH REPLANTED EXTREMITIES

Aim. To increase the efficiency of revascularization of replanted extremity segment by means of including indirect endolymphatic heparin therapy into complex of medical measures. Materials and methods. The results of complex treatment of 42 patients with traumatic amputation of extremity segments are presented in the paper. In the postoperative period, treatment of patients of the main group (22 patients) included, along with traditional, prolonged lymphotropic anticoagulant therapy using 1% methylene blue in complex with heparin. The results were estimated with standard clinicolaboratory studies and arterial and venous ultrasound investigation. Results. Clinical analysis carried out in the main group of patients showed decrease in the number of microvascular anastomoses venous thromboses of replanted extremity segments from 20% to their absence ( p >0,05), decline in purulo-necrotic complications from 15% to their absence ( p >0,05), rise in the total number of satisfactory results for extremity segments’ replantation from 60% to 81,81% ( p <0,05) and reduction in bed-days from 28,89±4,12 to 23,13±5,07 ( p >0,05). Conclusion. Lymphotropic anticoagulant therapy using 1% methylene blue with heparin associated with standard introduction of heparin to patients with replanted extremities contributes to reduction of risk of developing venous thromboses of microvascular anastomoses by 20%, allows to reduce the terms of hospital period by 19,97% and can be an additional method for prevention of purulo-necrotic complication development in patients with replanted extremities.

Microsurgery, extremity replantation, indirect endolymphatic therapy, adults, human being