Ectopic Banking and Implantation of an Amputated Hand

Omid Liaghat,Zohre Shabbooie

doi:10.1007/s43465-020-00078-7

Abstract

BackgroundEctopic banking includes techniques and indications used to bank amputated body parts for later replantation when a body part is amputated in its entirety. Immediate replantation is sometimes impossible due to hemodynamic instability, soft tissue loss, and extensive contamination of the amputated part. The first case of temporary ectopic banking of hand implantation was reported in 2015 by Xu Zhang in China which was not completely successful. The first replantation was reported almost 54 years ago, followed by a limited number of similar cases that were not successful. Xu could not restore the useful function of the replanted hand.PurposeIn this study, we reported a case of hand replantation by the banking technique.MethodWe carried out a hand replantation by the banking technique using the right ankle as the recipient site.ResultWe restored the useful function of the amputated part and evaluated the function with standard tests.ConclusionUsing right ankle as recipient site in ectopic banking can be a useful approach which helps and ensures the researchers and surgeons to decide if they intend to use this method.

Highlights

Ectopic banking, initially defined by Godina in 1986, includes techniques and indications used to bank amputated body parts for later replantation [1]
When a body part is amputated in its entirety, immediate replantation is sometimes impossible due to hemodynamic instability, soft-tissue loss, and extensive contamination of the amputated part [3]
We describe our experience with hand replantation by the banking technique

Summary

Introduction

Initially defined by Godina in 1986, includes techniques and indications used to bank amputated body parts for later replantation [1]. Proximal stump of radial and ulnar arteries was damaged up to 5 m proximal to radius amputation level. Two operative sessions of debridement were performed 3 and 5 days after banking to prepare the proximal stump for final transfer (Fig. 4). On the 8th day, banked wrist was harvested with 15 cm posterior tibia artery and 35 cm saphenous vein pedicles Six days later, exposed distal dorsal forearm was covered with a groin flap (Fig. 6). After 2 weeks, the groin flap pedicle was incised and more proximal dorsal exposed muscle area was covered with split thickness skin graft. The patient had no pain, weakness, or any other complaints from the donor site on the leg by the end of the follow-up

Discussion

Conclusion