Return-to-Work After Attempted Digit Replantation: A Systematic Review of 31 Studies
Research article published in Hand (New York, N.Y.) (2024)
Abstract
BACKGROUND: Traumatic digit amputation is a common injury with life-altering consequences for thousands of patients each year. In this study, we aim to update and expand the reported outcomes of return-to-work (RTW) and functional recovery in patients treated with digit replant after traumatic amputation. METHODS: A PRISMA-guided systematic review was performed to identify all published articles related to digit replantation following amputation. We queried the following 4 databases: Scopus, Embase, Web of Science, and PubMed-MEDLINE. A total of 31 studies were included in the analysis of return-to-work data. RESULTS: Of the 31 included studies, 26 studies reported that 1976 digits were successfully replanted, while 27 studies reported that 300 replants failed (86.8% success rate). Among 1087 patients in these studies, 82.9% who underwent replantation returned to work. The mean RTW time in 16 studies was 4.7 months (weighted average). Return-to-work time ranged from 0 to 26 months in 12 studies. Of 352 patients who returned to work in 17 studies, 90.9% resumed their previous occupation, while 29 (8.2%) changed occupations. The RTW for finger-only replantations was significantly lower compared to thumb-only, distal digit-only, and any digit replantations (66.0% vs 82.8%; 66.0% vs 87.6%; 66.0% vs 82.9%). CONCLUSION: Despite a declining prevalence of digit replantation surgery in recent years, this study illustrates that replantation provides beneficial outcomes for patients with a high return-to-work rate.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.
Why This Matters for Hirudotherapy
This PRISMA-guided systematic review of 31 studies examined return-to-work (RTW) and functional recovery after digit replantation following traumatic amputation, reporting an 86.8% replant success rate, an 82.9% RTW rate among 1,087 patients, a weighted mean RTW of 4.7 months, and notably lower RTW for finger-only replants (66.0%) than for thumb-only, distal-digit, or any-digit replants. For hirudotherapy this matters because medicinal leeches are an established adjunct for relieving venous congestion in replanted digits and microvascular flaps, so the favorable functional outcomes documented here describe exactly the salvage setting in which leech therapy is deployed to protect a threatened replant. Honest caveat: this is a systematic review summarizing heterogeneous published studies and does not assess leech therapy itself or attribute any outcome to it; it provides context for the replantation field, not direct evidence for hirudotherapy.
Citation
Return-to-Work After Attempted Digit Replantation: A Systematic Review of 31 Studies.
Treger et al. · Hand (New York, N.Y.), 2024
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