The timing of neovascularization in fingertip replantation by external bleeding
Research article published in Plastic and reconstructive surgery (2002)
Abstract
To overcome venous congestion in fingertip replantation with no venous anastomosis, the authors have used a salvage procedure that consists of continuous external bleeding through a stab incision on the paraungual area and dripping a heparinized saline solution at the incision site to maintain external bleeding. Because this method requires continuous bleeding for a certain period of time, it may be a great burden on the patient; therefore, it is most important to minimize the duration of bleeding. Many authors have studied the timing of the new venous channel formation of the flap. However, to our knowledge, a study on fingertip replantations has not yet been performed. From June of 1985 to November of 1999, the authors performed fingertip replantations on 144 fingers of 137 patients using our salvage procedure at Korea University Guro Hospital. Among the 144 fingers, 101 fingers of 96 patients were successfully transplanted, including those with partial necrosis. The authors reviewed the medical records of these 101 fingers retrospectively; they compared and analyzed the necessary duration of external bleeding according to sex, age, level of injury, cause of amputation, and the type of injury. The average period of the salvage procedure was 7.6 days. Regarding age, the shortest period (5.5 days) was required for patients younger than 10 years. On the basis of the types of injuries, the duration of bleeding was shortest for the guillotine injury group (5.9 days) compared with crush (8.2 days) or avulsion (8.0 days) injuries. Sex and level of injury did not make much difference in the duration of the procedure.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.
Por qué esto importa para la hirudoterapia
Esta revisión retrospectiva de 101 replantes exitosos de punta de dedo (de 144 intentados) estudió un método de salvamento para la congestión venosa en dedos que carecen de una anastomosis venosa: sangrado externo controlado continuo a través de una incisión punzante con solución salina heparinizada, mantenido hasta que se formen nuevos canales de salida venosa. La duración promedio del procedimiento de sangrado fue de 7.6 días, siendo la más corta en niños menores de 10 años (5.5 días) y en lesiones por guillotina (5.9 días) frente a lesiones por aplastamiento (8.2) o avulsión (8.0). Esto es altamente relevante para la hirudoterapia porque las sanguijuelas medicinales se utilizan precisamente para este problema fisiológico, descongestionando el tejido al inducir un sangrado prolongado mientras se establece la neovascularización venosa, por lo que el cronograma del resumen brinda a los clínicos una idea realista de cuántos días de descongestión pueden requerir tales replantes. La advertencia honesta: este artículo estudió una técnica de incisión punzante y heparin, no sanguijuelas, por lo que informa sobre la ventana biológica para la descongestión en lugar de validar la terapia con sanguijuelas y, al ser una serie retrospectiva de un solo centro, sus cifras de tiempo son descriptivas y no una comparación controlada.
Citación
The timing of neovascularization in fingertip replantation by external bleeding.
Han et al. · Plastic and reconstructive surgery, 2002
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026