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.
Resumen
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.
Por qué esto importa para la hirudoterapia
Este estudio observacional retrospectivo unicéntrico (116 pacientes, 157 dedos) identificó el tiempo de isquemia, la duración de la cirugía, las complicaciones postquirúrgicas y la necesidad de reimplante (frente a revascularización) como predictores significativos de la supervivencia del dedo tras reimplante o revascularización, mostrándose la revascularización con una mayor tasa de éxito. La relevancia para el ámbito de ASH es indirecta: este estudio versa sobre factores pronósticos en microcirugía digital, un escenario en el que las sanguijuelas medicinales se utilizan en ocasiones para tratar la congestión venosa, pero no se mencionan sanguijuelas. No se aportan datos sobre la terapia con sanguijuelas, el secretoma ni los adyuvantes para la congestión venosa. El estudio es retrospectivo y unicéntrico, lo que limita la generalizabilidad, y no ofrece evidencia directa relevante para la práctica de la hirudoterapia.
Citación
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
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026