检索结果-南通市图书馆

Tourniquets do not increase the total blood loss or reamputation risk in transtibial amputations

World Journal of Orthopedics 2017年第1期8卷 62-67页

作者： Christian Wied Peter T Tengberg Gitte Holm Thomas Kallemose Nicolai B Foss Anders Troelsen Morten T Kristensen Depart-ment of Orthopedic Surgery Copenhagen University Hospital Hvidovre Clinical Research Centre Copenhagen University Hospital Hvidovre Department of Anesthesiology and Intensive Care Copenhagen University Hospital Hvidovre Physical Medicine and Rehabilita-tion Research--Copenhagen Department of Physical TherapyCopenhagen University Hospital Hvidovre

AIM To investigate the total blood loss(TBL) and the safety with respect to the re-amputation rate after transtibial amputation(TTA) conducted with and without a tourniquet. METHODS The study was a single-centre retrospective cohort study of patients with a primary TTA admitted between January 2013 and April 2015. All patients with a primary TTA were assessed for inclusion if the amputation was performed because of arteriosclerosis or diabetic complications. All patients underwent a standardized TTA procedure that was performed approximately 10 cm below the knee joint and performed with sagittalflaps. The pneumatic tourniquet, when used, was inflated around the femur to a pressure of 100 mmH g above the systolic blood pressure. The number of blood transfusions within the first four postoperative days was recorded. The intraoperative blood loss(OBL), which is defined as the volume of blood lost during surgery, was determined from the suction volume and by the weight difference of the surgical dressings. The trigger for a blood transfusion was set at a decrease in the Hgb level < 9.67 g/dL(6 mmol/L). Transfusions were performed with pooled red blood cells containing 245 m L per portion, which equals 55 g/L of haemoglobin. The TBL during the first four postoperative days was calculated based on the haemoglobin level and the estimated blood volume. The re-amputation rate was evaluated within 30 d. RESULTS Seventy-four out of 86 consecutive patients who underwent TTA within the two-year study period were included in the analysis. Of these, 38 were operated on using a tourniquet and 36 were operated on without using a tourniquet. There were no significant preoperative differences between the groups. The patients in both groups had a postoperative decrease in their Hgb level compared with preoperative baseline values. The patients operated on using a tourniquet received approximately three millilitres less blood transfusion per kilogram body weight compared with patients o

关键词： Total blood loss Intraoperative blood loss transtibial amputation Lower extremity amputation Pneumatic tourniquet Re-amputation

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Voluntary Thigh Muscle Strength with Resection Stump-Dependent Blood Flow and Vasodilation in an Amputated Lower Leg with Total Surface Bearing Prosthesis during Dynamic Knee Extensor: A Case Trial

引用

Open Journal of Therapy and Rehabilitation 2019年第4期7卷 151-169页

作者： Takuya Osada Masahiro Ishiyama Ryuichi Ueno Rehabilitation Center Tokyo Medical University Hospital Tokyo Japan Cardiac Rehabilitation Center Tokyo Medical University Hospital Tokyo Japan

Background: The magnitude of the hyperemic response due to repeated thigh stump exercise on incremental contraction intensity might be useful information in localized exercise tolerance for devising cardiovascular physical therapy for amputees. The effect of exercise on amputated leg blood flow (LBF) may potentially be altered due to voluntary muscle contractions after loss of the lower leg compared with the healthy leg. Case Presentation: A 57-year-old male patient with Burger disease attempted 3 min unilateral repeat/dynamic knee extensor exercise at a target muscle contraction frequency (1 s thigh muscle contraction and 1 s relaxation, 90 repetitions) with each leg transtibial amputated leg (AL) using a total surface-bearing prosthesis (TSB) and left non-AL> at six different contraction intensities (rubber resistance belt). Simultaneous measurement of blood velocity/flow (Doppler ultrasound) in the femoral artery, blood pressure, leg vascular conductance (LVC), and peak muscle strength (PMS) were performed during the 3 min exercise period. The maximum voluntary contraction by one-legged isometric knee muscle contraction was 14.7 kg in non-AL and 7.9 kg in the AL with prosthesis. The relative PMS was defined as “PMS/maximum voluntary contraction × 100 (%)”. Pre-exercise LBF was lower in the AL (200 ± 25 ml/min) than the non-AL (275 ± 74 ml/min). Both the non-AL and AL showed good positive linear relationships between absolute-/relative-PMS and LBF or LVC during 30 s at steady-state before the end of the exercise period. Furthermore, there was also similarity seen in the increase rate in LBF and/or LVC for the incremental relative PMS compared with the absolute PMS. Conclusion: In this case, the muscle strength depended on blood flow increase/vasodilation was seen in this “AL” using a TSB prosthesis for repeated dynamic knee extensor exercise. The present amputee’s limb muscle strengthening with the resection stump closely related to the degree of hyperemia

关键词： Exercising Leg Blood Flow Vasodilation transtibial Amputation Total Surface Bearing Prosthesis Doppler Ultrasound

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Analysis of trans tibial prosthetic socket materials using finite element method

引用

Journal of Biomedical Science and Engineering 2011年第12期4卷 762-768页

作者： Prasanna Kumar Lenka Amit Roy Choudhury 不详

The objective of this work was to analyze in a parametric study for optimum design solution of prosthetic socket material by finite element method. A realistic three-dimensional finite element model of the PTB socket was developed to find out the stress distribution pattern under physiologically relevant loading condition during normal walking. The CAD model of the rectified socket was collected from a CMET 250 non-tactile high accuracy (0.06 mm) white light scanner and analyses were carried out using finite element Method in ANSYS?. All structural materials used in the analysis were assumed to be linearly elastic, homogeneous and isotropic. Different materials were used for socket and only polypropylene was used for socket adopter. Analysis was prepared at 2 mm, 3 mm, 4 mm, 5 mm & 6 mm thickness of socket in different materials commonly used in developing countries. The bottom line of socket was made to zero displacement constraints and vertical loads in relation to stance phase of gait cycle were applied under static condition at the patella tendon brim. The 3 mm laminated composite sockets was found to be optimum in terms of strength, weight and factor of safety.

关键词： Finite Element Method transtibial Prosthesis Socket Polymer

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：