Success rates of finger revascularization and replantation
Retrospective study published in Plast Reconstr Surg Glob Open (2024)
Abstract
BACKGROUND: Revascularization surgery has been reported to have a higher success rate than replantation due to sufficient venous return. However, in complex cases, success depends on a wide range of indications. This study aimed to investigate success rates in cohorts that included severe cases. METHODS: This single-center, noninterventional, retrospective cohort study included 292 patients (349 digits) who underwent revascularization or replantation at our institution between January 2000 and December 2022. Sex, age, smoking history, comorbidities, affected digit, amputation level, complete or incomplete amputation, type of fracture and mechanism, artery diameter, needle, vein anastomosis in the revascularization subgroup, vein grafting, warm ischemic time, and outcomes were investigated and compared between the revascularization and replantation subgroups of the distal and proximal amputation groups. RESULTS: In the distal amputation group, the arterial diameter in the revascularization subgroup was larger than that in the replantation subgroup (P < 0.05). In the proximal amputation group, the revascularization subgroup had a lower frequency of multiple amputations than the replantation subgroup (P < 0.05). Vein grafts were more frequently used in both revascularization subgroups than in the replantation subgroups (P < 0.05). However, the other injury severity indices were similar, and the success rates were not significantly different between the subgroups. CONCLUSIONS: The revascularization success rate was similar to that of replantation. Vein anastomosis or vein grafting to the veins should be advocated for revascularization in severe cases where skin bridges may not have sufficient venous return.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Retrospective analysis of finger revascularization and replantation success rates.
Why This Matters for Hirudotherapy
This retrospective cohort study evaluated the success rates and injury severity indices of 292 patients (349 digits) undergoing finger revascularization or replantation over a 22-year period. The abstract emphasizes that venous return via vein anastomosis or grafting is crucial for successful revascularization in severe cases. Venous congestion is a primary indication for hirudotherapy in reconstructive surgery, suggesting a clinical intersection where leeches are typically used to salvage compromised digits. However, the abstract strictly focuses on surgical outcomes and makes absolutely no mention of leeches, medicinal leech therapy, or the leech secretome. Therefore, its relevance to ASH is entirely unstated and only theoretical.
Citation
Success rates of finger revascularization and replantation.
Kobayashi et al. · Plastic and reconstructive surgery. Global open, 2024
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