Impact of the number of veins repaired in short-term digital replantation survival rate
Retrospective cohort published in JPRAS (2015)
Abstract
BACKGROUND: Venous congestion/insufficiency plays a major role in failure of finger replantation. Despite acceptable salvage rates with postoperative anticoagulation or leeching, operative technique remains the most important predictor of success. However, there are no indications in the literature on the benefit of anastomosing single versus multiple veins. METHODS: A retrospective review of finger amputations from 2011 to 2013 was conducted. The analyzed endpoint was the finger survival rate at discharge depending on the number of veins repaired: multiple veins (group 1), only one vein (group 2), or no veins (group 3). Proportions were compared using v2 tests/Fisher's exact tests; p-value <0.05 was considered significant. RESULTS: Seventy-two patients with complete digital amputation were operated including 101 fingers. Twenty-seven fingers (26.7%) failed before hospital discharge, with 78% of failures due to venous complications versus 22% with an arterial etiology. Group 2 had 15 replantation failures due to venous causes as opposed to only one from group 1, representing a 1.27-fold (95% confidence interval (CI): 0.99, 1.34) increased relative risk of failure (p = 0.032). Similarly, five fingers from group 3 suffered venous complications, resulting in a 1.49-fold (95% CI: 1.02, 1.73) increased likelihood of failure in comparison to group 1 (p = 0.008). No significant difference was observed between having only one vein repaired versus none (RR: 1.1792, 95% CI: 0.83, 2.10, p = 0.502). CONCLUSION: Efforts toward favoring two-vein repair lead to better survival of the replanted fingers. More cases need to be analyzed before formulating conclusions on specific levels of amputation with regard to venous anastomoses.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Across 72 patients and 101 finger replantations, 78% of failures were due to venous complications; two-vein repair was associated with significantly higher survival than single-vein repair, helping define when leech adjunct is most needed.
Por qué esto importa para la hirudoterapia
Este estudio retrospectivo examinó el impacto del número de venas reparadas en las tasas de supervivencia a corto plazo en 101 dedos reimplantados en 72 pacientes, encontrando que la reparación de múltiples venas produjo una supervivencia significativamente mejor en comparación con la reparación de una sola vena o sin reparación venosa, y que las complicaciones venosas representaron el 78 % de los fracasos. La aplicación de sanguijuelas se menciona en los antecedentes como una opción de rescate para la congestión venosa, pero el enfoque del estudio es la técnica quirúrgica. Para ASH, esto es solo indirectamente relevante: el resumen no reporta desenlaces, indicaciones ni eficacia de la terapia con sanguijuelas, y la sanguijuela se menciona solo de pasada como coadyuvante postoperatorio. El valor del estudio para ASH se limita a contextualizar la congestión venosa como causa principal de fracaso del reimplante, un problema para el cual la hirudoterapia se emplea en ocasiones.
Citación
Impact of the number of veins repaired in short-term digital replantation survival rate.
Efanov JI et al. · Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 2015
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Añadido a la biblioteca ASH: May 26, 2026 · Última actualización del sitio: 18 de junio de 2026