Donor transplant fingers usually has nothing to do with the bodies taken from other people. This is understandable. Despite recent advances in medicine, transplantation of any organ or tissue from other people always carries a high risk of rejection. That's why doctors are forced to spend immunosuppressive therapy, overwhelming its own immune system, which also adds health patients. The very selection of organs and tissues from other donors is very long, careful and time-consuming, because to achieve the selection of patients who will be most compatible tissue. Fortunately, the donor fingers transplant usually does not require specialists to find donors.
In most cases, uses its own organs and tissues. This donor tissue is called autograft. The fact that the area of the palm of the hand is only 1% of the total area of human skin. This knowledge is used to determine the area of skin lesions by hand (eg, burns). This means that in the case of donor transplant requires finger flaps of skin area less than 1%.
Donor sites can be a separate area of the skin, and the whole finger. Consequently, there are two fundamentally different approaches to transplanting fingers: reconstruction of fingers with skin (or skin-bone) grafts transplant donor finger with microsurgical technique.
Reconstruction of the fingers with skin grafts. This recovery method is used in the finger where the bone foundation that your finger has not been damaged and is not only a skin flap, which is taken usually from the surrounding areas. For example, for the first finger donor may be the second or third finger, the second - the third for the third - the second or fourth, etc.
Usually transplanted skin with subcutaneous fat and fascia. They cut out from the side, the dorsolateral or the rear surface of the donor finger if necessary. For example, if significantly damaged index finger pad, the donor site is usually the rear surface of the middle phalanx of the third finger.
What to do with skin defect formed on the adjacent finger? For him, taking a skin flap from another part of the body where it can safely pull and sew without prejudice to the aesthetics and function. Typically, for these purposes the inner surface of the shoulder or upper arm. Direct transfer from the shoulder is not suitable because the skin flap from the adjacent finger is not cut out all at once, and only an incision around the circle so that on one side of it remained intact and continued to eat from one of the vessels. In this case, healing is faster and less painfully.
In case of damage of the nail phalanx often use skin from the palmar surface of the same hand. Semicircular incision is made and the finger, which requires the restoration of this area stitched to the skin on the palms. After implantation and germination of its own vessels in the thickness of the transplanted tissue meets the rest of the area of the skin and finally formed shape of the finger. This usually takes about 3 weeks.
If the patient is not willing to part with his fingers on his leg, and finger defect is significant, then one must resort to other methods, such as the formation of a finger with skin and bone graft in the forearm vascular pedicle.
In the event of a significant loss of tissue transplantation using a donor of a finger or part of it. Most often used for this purpose toes. To restore the length, shape and functionality of transplanted toe or part of it is the best solution, because it does not require significant effort to create the appearance of the finger. However, some patients may refrain from microsurgical transplantation of fingers, due to fear of violation of the appearance or function of the lower limb after transplantation.
Fortunately, the long experience of such transplants shows marked advantages of the method against the minimum of disadvantages:
High aesthetic restoration of the lost finger. The absence of a finger on the hand strongly noticeable change thumb and fully recovers its structure. The similarity of the structure of the fingers and toes can make the most natural form of the hand.
Restoration of lost function. The fact is that not only restored the structure and basic functions. Through the use of microsurgical technique restores sensitivity of the fingers, allowing most patients to fully return to usual work.
No significant changes in the structure and function of the foot. Loss of one finger (usually the latter) is not obvious and not immediately visible on the leg. Given that the toes rarely attract attention or for show, the operation becomes even less significant in terms of aesthetics. It is also important that a missing finger is not a yawning: the third finger as close to the first and this defect becomes even less noticeable.
There are other options for plastic fingers through donor sites of his own body. The type of surgery is determined in each case individually, and is consistent with the patient.
