Replantation of digits: a review of predictive factors for survival

The Journal of Hand Surgery, European Volume
A BreahnaF C Iwuagwu

Abstract

The survival of 75 consecutive digital replantations carried out between 2006 and 2010 at a regional hand centre in the United Kingdom was determined. The patient demographics, mechanism of injury, co-morbid factors, operative and post-operative details were extracted and reviewed from the medical and hand therapy notes. Predictive factors of survival were determined by using univariate and multivariate statistical analysis. The survival rate was 70%. Arterial thrombosis was the leading cause of replant failure, followed by venous congestion. Smoking, level of amputation, number of nerves repaired, warm ischaemia time and timing of replantation were independent predictors of replant survival. However, only warm ischaemia time less than 6 hours and 30 minutes and replantations done within 'office hours' showed significance on multivariate logistic regression. Our study suggests that replantations done in daylight hours, when feasible, with rested staff and a full complement of the theatre team are likely to have better outcomes. Level IV case series.

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Citations

Apr 23, 2017·Microsurgery·Johnny I EfanovAlain M Danino
May 2, 2018·The Journal of Bone and Joint Surgery. American Volume·Hongyi ZhuXianyou Zheng
May 4, 2018·The Journal of Hand Surgery, European Volume·Tao WangJing-Yi Mi
Aug 9, 2017·The Journal of Hand Surgery, European Volume·Murat KayalarYalçın Ademoğlu
Jun 22, 2018·Plastic and Reconstructive Surgery·Chin-Yu YangHui-Yi Hsiao
Apr 18, 2017·The Journal of Hand Surgery, European Volume·Jkf WongC C Hsu
Sep 25, 2017·Scientific Reports·Hongyi ZhuXianyou Zheng
Nov 7, 2019·Plastic and Reconstructive Surgery·Sang Hyun Woo
Mar 1, 2017·Der Unfallchirurg·H Vester, S Deiler
Feb 6, 2017·International Orthopaedics·Xiaozhong ZhuXianyou Zheng
Aug 14, 2020·Journal of Hand and Microsurgery·Ashkaun ShaterianAmber Leis
Mar 25, 2021·The Journal of Hand Surgery, European Volume·Fethiye Damla Menkü ÖzdemirAli Emre Aksu
Aug 14, 2021·The Journal of Hand Surgery, European Volume·Matthew FlorczynskiHeather Baltzer
Aug 12, 2021·The Journal of Hand Surgery·Patrick W HarbourAviram M Giladi
Aug 17, 2021·Plastic and Reconstructive Surgery·Alicia R BillingtonJason Nydick
Jul 31, 2019·International Journal of Surgery·Hanqiang JinChangqing Zhang
Oct 9, 2021·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Burak Sercan ErçinFatih Kabakaş

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Methods Mentioned

BETA
amputation
amputations

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