Surgical treatment of distal digit amputation: Success in distal digit replantation is not dependent on venous anastomosis
Journal
Plastic and Reconstructive Surgery
Journal Volume
135
Journal Issue
1
Pages
174-178
Date Issued
2015
Author(s)
Abstract
Background: Although digit amputation at or distal to the distal interphalangeal joint is a common injury, it remains a challenging problem to restore digital length and pulp because of the lack of healthy vessels and the absence of proper vascular size for reanastomosis. The purpose of the present study was to review the authors' clinical experience with distal digital replantation and to test the hypothesis that success in distal digit replantation is not dependent on venous anastomosis. Methods: Twenty-eight patients with 31 complete distal digit amputations were included in the study. Data regarding patient demographic, replantation technique, and surgical outcome were analyzed. Results: Sixteen digits were replanted with arterial and venous anastomoses (group A). Eleven digits were replanted with only arterial anastomosis (group B). Composite grafting was performed in four digits without vascular anastomosis (group C). The success rates in group A and group B were 81.3 and 81.8 percent, respectively. None of the composite grafts survived. Fisher's exact test was used for statistical analysis. Although group C has the lowest survival rate (p < 0.05), the differences between the survival rates in group A and group B (p > 0.05) were insignificant. Conclusions: The overall success rate of distal digit replantations in the authors' series was 81 percent, and there were no differences in the survival rates between replantations with and without venous anastomosis. Finally, the authors conclude that success in distal digit replantation is not dependent on venous anastomosis and suggest that replantation should be encouraged in complete distal digital amputation, even without venous anastomosis. Copyright ? 2014 by the American Society of Plastic Surgeons.
SDGs
Other Subjects
adolescent; adult; aged; Amputation, Traumatic; anastomosis; child; Finger Injuries; human; middle aged; preschool child; procedures; reimplantation; retrospective study; survival rate; vein; young adult; Adolescent; Adult; Aged; Amputation, Traumatic; Anastomosis, Surgical; Child; Child, Preschool; Finger Injuries; Humans; Middle Aged; Replantation; Retrospective Studies; Survival Rate; Veins; Young Adult
Type
journal article