Document Detail


Fingertip amputation salvage on arterial anastomosis alone: an investigation of its limitations.
MedLine Citation:
PMID:  20733365     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We have previously reported the importance of adequate and precise arterial anastomosis and the hypothesis that, up to subzone III, fingertip amputation salvage can be achieved on arterial anastomosis alone. These findings were reported during the meeting of the Japanese Society of Reconstructive Microsurgery. This is our follow-up report with insight and opinion on the limitations of complete fingertip amputation salvage on arterial anastomosis alone.
METHODS: We examined 67 fingers (59 patients) with fingertip amputations presenting to our hospital between January 2005 and December 2008. Amputation levels and whether these injuries received only arterial or both arterial and venous anastomoses were noted. Fisher exact test was used to examine statistical differences between the groups.
RESULTS: Amputation levels were 11 in subzone I, 20 in subzone II, 17 in subzone III, and 19 in subzone IV. Successful replantation was achieved in 87% (58 of 67) of fingers. There was no statistically significant difference between fingers receiving arterial alone versus both anastomoses in amputations of subzones I, II, and III.
CONCLUSIONS: We found that with proper postoperative congestion care, no statistically significant difference in replantation success of fingers receiving arterial anastomosis alone versus both arterial and venous were noted up to subzone III. However, in subzone IV, regardless of the postoperative congestion, compete necrosis rates are high; thus, it is speculated that a venous anastomosis is necessary for successful replantation. It is preferable to perform as many anastomoses as possible, but we believe that it is also desirable for the procedure to be fast and less invasive. In cases that have no adequate vein, fingertip replantation can be achieved on arterial anastomosis alone up to subzone III.
Authors:
Hiroshi Ito; Kenji Sasaki; Kousuke Morioka; Motohiro Nozaki
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of plastic surgery     Volume:  65     ISSN:  1536-3708     ISO Abbreviation:  Ann Plast Surg     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-24     Completed Date:  2010-12-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7805336     Medline TA:  Ann Plast Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  302-5     Citation Subset:  IM    
Affiliation:
Department of Plastic and Reconstructive Surgery, Kawaguchi Municipal Medical Center, Saitama, Japan. ihiroshi@coffee.ocn.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Amputation, Traumatic / surgery*
Anastomosis, Surgical / methods*
Child
Female
Finger Injuries / surgery*
Fingers / blood supply*,  surgery
Follow-Up Studies
Humans
Japan
Male
Middle Aged
Replantation / methods*
Treatment Outcome
Vascular Surgical Procedures / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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