METHOD FOR TREATING NERVE STUMP IN MAKING EXTREMITY AMPUTATION

摘要

medicine. SUBSTANCE: method involves MAKING extremity amputation according to method indicated fro the patient. Nerve trunk is selected and the nerve is laid at the distance of 4.0-7.0 cm proximal relative to amputation level using injection needle and anesthesia is done at the whole length of the injection needle in prolonged mode in proximal direction with lidocaine solution having 3-5 adrenaline solution drops. Dense creeping intraneural infiltrate is created. The injection needle is pulled by 1.0-1.5 cm. The nerve is temporarily ligated 0.5 cm in proximal direction with respect to the marked level for truncating nerve with strong catgut ligature in one simple angle. The ligature ends are tightened. 5.0-8.0 ml of 40-45% ethyl alcohol solution are injected into the nerve in bolus mode. The nerve trunk is truncated in distal position relative to the ligature applied to the nerve using sharp shaving blade at 0.5 cm large distance from it. 4.0-6.0 cm long fragment is cut out from deep large diameter vein and put over the nerve stump as an envelope. The end with adjacent epineurium is coagulated with light radiation. The nerve end surface with adjacent epineurium is treated with high intensity defocused laser radiation of 230-390 W/cm2 power and the laser beam is moved at 0.5 cm/s speed. The upper slice of the autovein fragment is attached to the epineurium with four thin catgut ligatures. The nerve stump is covered with autovein fragment at the level of thick catgut ligature used for stump edge finishing by applying surgical knot. A part of 0.4-0.6 cm long venous fragment is retained in distal position relative to the thick catgut ligature. EFFECT: enhanced effectiveness and quality of nerve stump treatment; prevented postoperative complications.