The use of local anaesthesia with epinephrine in the harvest and transfer of an extended Segmuller flap in the fingers

The use of local anaesthesia with epinephrine in the harvest and transfer of an extended... Short report letter Journal of Hand Surgery (European Volume) 0(0) 1–2 journals.sagepub.com/home/jhs patients required the use of a temporary tourniquet The use of local anaesthesia with and our technique achieved adequate bleeding con- epinephrine in the harvest and transfer of trol although we noted minor bleeding in the field during dissection. Most importantly, we noted an extended Segmuller flap in the fingers normal pulsation of the digital artery in the flap ped- Dear Sir, icle throughout the entire harvesting and transfer- Local anaesthesia with epinephrine has been widely ring process (Figure 1). No patients required considered a contraindication for flap transfer in the termination of the procedure because of intraopera- fingers. However, we found that this consideration tive pain, and the blood supply to all the flaps recov- may not be true. Epinephrine has only transient vaso- ered within 4–5 hours after the injections. Five flaps constrictive effects on the capillaries rather than survived completely without overt venous congestion on main arteries. It would not result in avascular or ischaemia, but one flap had a 3 mm wide strip of necrosis of the flap over 4–5 hours. In a few patients, skin necrosis in the most distal part of http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Hand Surgery (European Volume): Journal of the British Society for Surgery of the Hand & Official Journal of the Federation of European Societies for Surgery of the Hand SAGE

The use of local anaesthesia with epinephrine in the harvest and transfer of an extended Segmuller flap in the fingers

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Publisher
SAGE Publications
Copyright
© The Author(s) 2018
ISSN
1753-1934
eISSN
2043-6289
D.O.I.
10.1177/1753193418780560
Publisher site
See Article on Publisher Site

Abstract

Short report letter Journal of Hand Surgery (European Volume) 0(0) 1–2 journals.sagepub.com/home/jhs patients required the use of a temporary tourniquet The use of local anaesthesia with and our technique achieved adequate bleeding con- epinephrine in the harvest and transfer of trol although we noted minor bleeding in the field during dissection. Most importantly, we noted an extended Segmuller flap in the fingers normal pulsation of the digital artery in the flap ped- Dear Sir, icle throughout the entire harvesting and transfer- Local anaesthesia with epinephrine has been widely ring process (Figure 1). No patients required considered a contraindication for flap transfer in the termination of the procedure because of intraopera- fingers. However, we found that this consideration tive pain, and the blood supply to all the flaps recov- may not be true. Epinephrine has only transient vaso- ered within 4–5 hours after the injections. Five flaps constrictive effects on the capillaries rather than survived completely without overt venous congestion on main arteries. It would not result in avascular or ischaemia, but one flap had a 3 mm wide strip of necrosis of the flap over 4–5 hours. In a few patients, skin necrosis in the most distal part of

Journal

Journal of Hand Surgery (European Volume): Journal of the British Society for Surgery of the Hand & Official Journal of the Federation of European Societies for Surgery of the HandSAGE

Published: Jan 1, 2018

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