Survival and Comparison of External Bleeding Methods in Artery-Only Distal Finger Replantations
| Autor: | Tahir Sadık Sügün, Tulgar Toros, Yalcin Ademoglu, Murat Kayalar, Yusuf Gürbüz, Özgün Barış Güntürk |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment 030230 surgery Amputation Surgical Fingers 03 medical and health sciences 0302 clinical medicine Amputation Traumatic Finger Injuries medicine Humans Orthopedics and Sports Medicine Survival rate Survival analysis 030222 orthopedics business.industry Fingertip amputation Anastomosis Surgical Large series Arteries Surgery medicine.anatomical_structure Amputation Replantation business Nail matrix Artery |
| Zdroj: | The Journal of Hand Surgery. 45:256.e1-256.e6 |
| ISSN: | 0363-5023 |
| DOI: | 10.1016/j.jhsa.2019.06.013 |
| Popis: | Purpose If there are no veins available in a distal amputation, an artery-only replantation is performed, and an external bleeding method is commonly used. We conducted a survival analysis in a large series of artery-only replantations and compared 2 different external bleeding methods in artery-only distal replantations: nail matrix or hyponychial area bleeding and pulp skin area bleeding, which we have called the crater method. Methods Two hundred twenty-eight artery-only distal finger replantations in 199 patients were included in the study. The replanted digits were divided into 2 groups according to the external bleeding methods. One group (n = 94; 41.2%) included the patients in whom the external bleeding was performed using a traditional nail bed incision and the second group (n = 134; 58.8%) included the patients in whom external bleeding was performed using the crater method. The finger survival rates and postoperative circulatory problems were examined. The impact of the injury mechanism, injury level, and external bleeding method on survival were evaluated. Results Clinical findings indicating venous insufficiency were observed in 198 (86.8%) replanted fingers. One hundred eighty-two (79.8%) survived, and complete necrosis developed in 46 (20.2%). Viability was maintained in 84% of patients treated with the nail bed bleeding method and 76.9% of patients treated using the crater method. Clean-cut cases had the best results and subzone 3 cases had the worst results. Conclusions The artery-only replantation was associated with a 79.8% survival rate. The method of achieving venous outflow did not appear to have an impact on survival. Type of study/level of evidence Therapeutic IV. |
| Databáze: | OpenAIRE |
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