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
В данном ретроспективном исследовании сравнивались результаты реплантации/реваскуляризации пальца и мякоти пальца у 21 пациента; установлено, что реплантация мякоти пальца характеризовалась более высокой жизнеспособностью (90% против 72%) несмотря на анастомоз с одним сосудом и более короткое время ишемии. Для сферы ASH значимость носит опосредованный характер — реплантация пальцев является контекстом, в котором терапия пиявками может применяться для лечения послеоперационного венозного застоя, однако в абстракте не упоминаются пиявки, гирудотерапия или секретом пиявки. Исследование сосредоточено на хирургических результатах и супрамикрохирургической технике. Данная статья не предоставляет прямых доказательств за или против какого-либо аспекта терапии пиявками.
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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