Digital replantation/revascularization: predictive factors to microsurgery success - a single-center study
Retrospective study published in Eur J Trauma Emerg Surg (2019)
Abstract
PURPOSE: Success rate in replantation/revascularization digital surgery is one of the challenges of reconstructive surgery. For this reason, investigating prognostic factors for survival and improvement of outcomes is highly relevant. The goal of this study was to establish predictive factors of survival in replantation/revascularization digital surgery. METHODS: A descriptive, retrospective study was performed in patients who underwent urgent replantation/revascularization digital surgery in our center between January 2007 and July 2017. A total of 116 patients and 157 digits were included. Outcome (survival) factors evaluated were: preoperatively: age, sex, body mass index (BMI), ASA anesthesia score, comorbidities (smoking status, diabetes mellitus, hypertension), coagulation, type of lesion, number of affected digits, position of affected digits, injury mechanism, ischemia time; time between accident and the surgery; intraoperatively: anesthetic technique, fluid therapy (administered volume), length of surgery; and postoperatively: post-surgical complications, re-intervention requirements, surgical success rate. Statistical analysis was performed to evaluate outcome and elicit predictive factors. RESULTS: 157 digits from a total of 116 patients were included. Statistically significant differences regarding predictors of survival of replantation were found in ischemia time (0 0.003), length of surgery (p 0.004), post-surgical complications (p 0.000) and replantation need (p 0.000). The rest of analyzed variables were not statistically significant (p > 0.05). Revascularization surgery had a greater success rate than replantation (p 0.001). CONCLUSIONS: Success rate in traumatic digital surgery is greater when revascularization surgery is performed, rather than replantation. Preoperative ischemia time, length of surgery, postoperative complications and re-intervention requirement are the factors that affect survival rate.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
10-year retrospective study of 157 digits in 116 patients identifying ischemia time, surgery length, and postoperative complications as predictors of digital replant/revascularization success. Revascularization > replantation.
Warum dies für die Hirudotherapie relevant ist
Diese retrospektive Observationsstudie an einem einzelnen Zentrum (116 Patienten, 157 Finger) identifizierte Ischämiezeit, Operationsdauer, postchirurgische Komplikationen sowie die Notwendigkeit einer Replantation (im Gegensatz zur Revaskularisation) als signifikante Prädiktoren für das Überleben des Fingers nach Replantation oder Revaskularisation, wobei die Revaskularisation höhere Erfolgsraten zeigte. Die Relevanz für das ASH-Domänenfeld ist indirekt: Diese Studie betrifft prognostische Faktoren in der digitalen Mikrochirurgie, einem Bereich, in dem medizinische Blutegel manchmal zur Behandlung der venösen Kongestion eingesetzt werden, jedoch werden Blutegel nicht erwähnt. Es werden keine Daten zur Blutegeltherapie, zum Sekretom oder zu unterstützenden Maßnahmen bei venöser Kongestion bereitgestellt. Die Studie ist retrospektiv und single-center, was die Generalisierbarkeit einschränkt, und sie liefert keine direkte Evidenz, die für die hirudotherapeutische Praxis relevant ist.
Zitation
Digital replantation/revascularization: predictive factors to microsurgery success - a single-center study.
Tejedor Navarro A et al. · European journal of trauma and emergency surgery, 2019
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