A technique for replantation of the finger tip
Case series published in Microsurgery (1989)
Abstract
The finger-tip replantation technique reported here has evolved over 15 years. Indications for surgery include both strong patient desire and specialized use of the finger tip. Palmar flaps are elevated as full-thickness skin grafts to avoid injury to palmar veins. Arteries and palmar digital veins are repaired using an open-vessel technique. Postoperative care varies from immediate discharge with follow-up to inpatient care using surgical leeches or continuous bleeding as a method of drainage should venous congestion develop. The survival rate of 26 finger tips replanted using this technique between 1981 and 1987 was 69%. Two-point discrimination returned in 75% of patients, and 25% had two-point discrimination of less than 5 mm. The distal interphalangeal joint retained an average range of motion of 56 degrees. Appearance was excellent, and patient satisfaction was high.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
26 fingertip replantations between 1981–1987 with 69% survival rate. Palmar flap full-thickness graft technique with arterial and palmar digital vein repair, and selective use of medicinal leeches or continuous bleeding for venous congestion control.
Why This Matters for Hirudotherapy
The article describes an evolving fingertip replantation technique used over 15 years, including elevation of palmar flaps as full-thickness skin grafts and repair of arteries and palmar digital veins by an open-vessel approach. It states that postoperative care may include surgical leeches or continuous bleeding if venous congestion develops, placing leech use within a reconstructive-surgery drainage pathway. Reported outcomes for 26 replanted fingertips included a 69 percent survival rate, restored two-point discrimination in 75 percent of patients, and high patient satisfaction. For ASH, the relevance is limited because leeches are mentioned only as a possible adjunct; the study provides no leech-specific outcomes or comparative hirudotherapy data.
Citation
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