A comparison of outcomes between finger and pulp replantation/revascularization
Systematic review published in Plast Reconstr Surg Glob Open (2023)
Abstract
UNLABELLED: Supermicrosurgery has allowed the replantation/revascularization of the pulp, but how does this currently compare with more proximal digit replantation/revascularization? METHODS: In a retrospective case study over a 5-year period at our institute, a total of 21 patients (n = 21) had either finger or pulp replantation-revascularization posttrauma. All pulp replants had a single-vessel anastomosis viz., "artery-to-artery" or "artery-to-vein" only, with venous outflow dependent on the skin-shave technique, while more proximal replants had both arterial and venous anastomoses. Age, sex, ischemic time, handedness, smoker status, and injury-replant interval were compared between the two groups, with all procedures performed by a single surgeon. The outcome parameters studied were length of hospital stay, timeline for wound healing, viability, and functional outcomes. RESULTS: Our patients consisted of 18 men and three women, of which 14.3% were smokers and 85.7% were right-handed. There were 11 finger replantation/revascularizations (n = 11) versus 10 pulp replantation/revascularizations (n = 10). The average age of digit replantation/revascularization patients was 44.8 years compared with 26.4 years in pulp replantation/revascularization patients (Student t test, P = 0.04). Mean ischemia time in digital replants was 67 minutes versus 32.3 minutes in pulp replantation/revascularization (Student t test, P = 0.056). Digital replantation/revascularization was viable in 72% of cases versus a 90% viability in the pulp subcohort. CONCLUSIONS: In our patient cohort, pulp replantation/revascularizations produced better postoperative viability. Where supermicrosurgery expertise is available, pulp replantation/revascularization should be considered a worthwhile option when compared with digital replantation/revascularization.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Резюме
Systematic review comparing finger versus pulp replantation/revascularization outcomes.
Почему это важно для гирудотерапии
This retrospective case study compared outcomes between finger and pulp replantation/revascularization in 21 patients, finding that pulp replantation had higher viability (90% vs. 72%) despite single-vessel anastomosis and shorter ischemia time. For ASH's domain, the relevance is indirect—digital replantation is a context where leech therapy may be used to manage postoperative venous congestion—but the abstract does not mention leeches, hirudotherapy, or the leech secretome. The study focuses on surgical outcomes and supermicrosurgical technique. This article offers no direct evidence for or against any aspect of leech therapy.
Цитирование
A comparison of outcomes between finger and pulp replantation/revascularization.
Duah-Asante et al. · Plastic and reconstructive surgery. Global open, 2023
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
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