Published in:
01-04-2015 | Original Paper
Results of upper limb digital and hand replant and revascularisation at a UK Hand Centre
Published in: European Journal of Plastic Surgery | Issue 2/2015
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Background
There is an increasing awareness of replantation amongst the general public, with an expectation for reattachment of digits. Currently, there is a paucity of evidence on the outcomes of replantation or revascularisations in the UK with most surgical experience literature from the USA or East Asian countries.
Methods
We report a case series of 28 patients over a 7-year period with replantation or revascularisation performed at a tertiary National Health Service hand centre in the UK. Data was collected retrospectively from hospital clinical notes and electronic imaging.
Results
Out of the 28 patients identified, 16 had single digit replantation or revascularisation, of which 11 digits ultimately survived. Nine patients underwent multiple digit replantation or revascularisation with a combined total of 25 digits, only five of these digits survived.
Conclusions
Factors found to adversely affect survival were increased number of attempted replants, power-saw mechanism of injury and prolonged ischaemic time. Reduced ischaemic times and single digit amputations were associated with improved survival.
Level of Evidence: level IV, risk/prognostic study.