Risk factors for reexploration in toe-to-hand transfer: a multivariate analysis of 363 cases
| Autor: | Steven Lo, Fu-Chan Wei, Shiuan-Tzuen Su, Chih-Hung Lin, Yu-Te Lin, Ching-Hsuan Hu |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Multivariate analysis Transplantation Heterotopic Transplants Transplantation Autologous Young Adult Postoperative Complications Ischemia Risk Factors Hand Deformities Acquired medicine Humans Surgical Wound Infection Retrospective Studies Hand deformity business.industry Medical record Hand Injuries Hand surgery Retrospective cohort study Thrombosis Staphylococcal Infections Toes medicine.disease Hand Surgery body regions Transplantation Venous thrombosis Multivariate Analysis Female business Hand Deformities Congenital |
| Zdroj: | Plastic and reconstructive surgery. 135(2) |
| ISSN: | 1529-4242 |
| Popis: | Background Reexploration after toe-to-hand transfer increases the risk of failure. In this study, the authors aimed to identify risk factors for reexploration after toe-to-hand transfer. Methods The medical records of 363 patients who underwent single toe-to-hand transfer between 2000 and 2010 were reviewed retrospectively. Patient demographics, clinical data, and operative data were collected, and multivariate analysis was performed. Results Of these 363 patients, 299 toes (82.4 percent) had primary success in transplantation. Sixty-four toes required reexploration, of which seven toes failed. The overall success rate was 98.1 percent. Of the 64 toes that required reexploration, arterial spasm was found in 39 (60.9 percent), arterial thrombosis was found in 27 (42.2 percent), and venous thrombosis was found in 16 (25.0 percent). Multivariate logistic regression analysis revealed that postoperative wound infection, metacarpal hand injuries, and preceding flap coverage were independently associated with reexploration. Conclusions Reducing reexploration in toe-to-hand transfer may be facilitated by managing or avoiding these risk factors. Particular attention must be paid to avoid postoperative wound infection, which was the single greatest factor contributing to reexploration (adjusted OR, 12.6). Clinical question/level of evidence Risk, III. |
| Databáze: | OpenAIRE |
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