Delayed Digit Replantation: What is the Evidence?
| Autor: | Aviram M. Giladi, Elizabeth Malphrus, Ryan M. Zimmerman, Patrick W. Harbour |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Ischemia Ischemic time Warm ischemia medicine.disease Amputation Surgical Numerical digit Fingers Limited access Amputation Traumatic Amputation Replantation Finger Injuries Humans Medicine Orthopedics and Sports Medicine Surgery business Intensive care medicine Cold ischemia |
| Zdroj: | The Journal of Hand Surgery. 46:908-916 |
| ISSN: | 0363-5023 |
| DOI: | 10.1016/j.jhsa.2021.07.007 |
| Popis: | A persistent challenge that has limited access and delivery of digit replantation surgery is timing, as ischemia time has traditionally been considered an important determinant of success. However, reports that the viability of amputated digits decreases after 6 hours of warm ischemia and 12 hours of cold ischemia are largely anecdotal. This review evaluates the quality and generalizability of available evidence regarding ischemia times after digit amputation and reported outcomes of “delayed” replantation. We identify substantial limitations in the literature supporting ischemia time cutoffs and recent evidence supporting the feasibility of delayed digit replantation. The current treatment approach for amputation injuries often necessitates transfers or overnight emergency procedures that increase costs and limit availability of digit replantation nationwide. Evidence-based changes to digit replantation protocols could lead to broader availability of this service, as well as improved care quality. |
| Databáze: | OpenAIRE |
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