Hand 

About: Hand is an academic journal published by SAGE Publishing. The journal publishes majorly in the area(s): Medicine & Wrist. It has an ISSN identifier of 1558-9447. Over the lifetime, 2922 publications have been published receiving 38821 citations.

Cigarette smoking: Impairment of digital blood flow and wound healing in the hand

Abstract: Smoking a single cigarette can reduce digital blood flow. Sarin (1974) showed a 42% reduction in digital blood flow in his series, and other investigators have shown similar findings (Ludbrook 1974, Rottenstein 1960). The focus of this paper is on the pharmacological effects of the various components of cigarette smoke and their potentials effects on wound healing in the hand. A case is described to illustrate the effect of stopping smoking upon a non-healing fingertip ulcer.

Limitations of Conduits in Peripheral Nerve Repairs

Abstract: Nerve conduits have emerged as alternatives to autologous nerve grafts, but their use in large-diameter nerve deficits remains untested. We report four patients who underwent repair of large-diameter nerves using absorbable nerve conduits and discuss the failed clinical outcomes. The reported cases demonstrate the importance of evaluating the length, diameter, and function of nerves undergoing conduit repair. In large-diameter nerves, the use of conduits should be carefully considered.

Early Clinical Outcomes with the Use of Decellularized Nerve Allograft for Repair of Sensory Defects Within the Hand

Abstract: Nerve conduits have become an established option for repair of sensory deficits of up to 2 cm. More recently, decellularized nerve allograft has also been advocated as an option for nerve repair; however, no clinical studies have examined its efficacy for the treatment of sensory nerve defects. The aim of this study was to examine our early experience with the use of decellularized nerve allograft for repair of segmental nerve defects within the hand and fingers. From July 2007 to March 2008, seven patients who had ten nerve gaps were treated surgically using decellularized nerve allograft. Eight digital and two dorsal sensory nerves were repaired. The etiologies of the nerve defects were traumatic nerve transection in eight defects and neuroma resection and reconstruction in two defects. All of the affected nerves were pure sensory fibers. Functional recovery was evaluated by blinded hand therapist using moving and static two point discrimination tests. Implantation sites were also evaluated for any signs of infection, rejection, or graft extrusion. There were five men and two women with a mean age of 44 years (range 23-65). Mean nerve graft length was 2.23 cm with a range of 0.5-3 cm. Mean follow up time was 9 months (range 5-12). Average two point discrimination was 4.4 mm moving and 5.5 mm static at last recorded follow-up. There were no wound infections observed around the graft material and sensory improvement was observed in all of the patients despite this short-term follow-up. Re-exploration of two fingers was required for flexor tendon rupture in one and flexor tendon tenolysis in the other. In both cases, the nerve allograft was visualized and appeared well incorporated in the repair site. Decellularized nerve allografts were capable of returning adequate sensation in nerve defects ranging from 0.5 to 3 cm. There were no cases of infection or rejection. Decellularized nerve allograft may provide an option for segmental nerve gaps beyond 2 cm. Randomized comparative studies will be required to determine efficacy in comparison to collagen conduits or nerve autograft.

Experimental Flexor Tendon Healing without Adhesion Formation — A New Concept of Tendon Nutrition and Intrinsic Healing Mechanisms A Preliminary Report

Abstract: An experimental model is presented enabling an analysis of the healing process of completely cut and re-sutured free segments of rabbit flexor tendons, kept avascular in a synovial milieu and completely isolated from adhesion formation. Under these conditions the cut tendons heal within a few weeks. It can be shown that this healing process is a result of intrinsic tendon cell activity only.

The “grasping” technique for tendon repair

Abstract: At the meeting of the American Society for Surgery of the Hand in Las Vegas in 1973, Urbaniak, Mortenson and Cahill presented an analysis of the tensile strength of various methods of tendon repair. Following this, many colleagues have requested details of the so-called \"grasping\" suture. It appears that neither the original publication (Kessler and Nissim, 1969), nor the presentation of Urbaniak (1973) clarified the technique of this suture. Moreover, from the nature of the questions I realised that the principle of the technique was somehow misinterpreted. Since the \"grasping\" suture is actually a simple and safe method for tendon repair, a further description of its details seems to be justified.