October 15, 2019
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Several factors associated with late digit replantation failure

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LAS VEGAS — Results presented at the American Society for Surgery of the Hand Annual Meeting showed leeching while in hospital and avulsion injury mechanism were associated with late digit replantation failures.

Of the 434 replanted digits retrospectively reviewed, Matthew Florczynski, MD, MSc, and colleagues found a success rate of 71%.

“Of the 82 failed procedures, 31 actually failed late,” Florczynski said in his presentation here. “That means that these patients were discharged from hospital with apparently viable digits that seemed to have succeeded, and then they showed up at some point in follow-up with digits that failed that required revision amputation.”

Florczynski noted the most common injury mechanism was blade mechanism, which was relatively more common among patients with successful replantation.

“Crush mechanism was relatively more common in the early failure group, and avulsion mechanism was relatively more common in later failure,” he said.

Florczynski added that leeching while in the hospital was associated with both early and late failure.

“Meanwhile, use of vein graft, which is typically used to mitigate arterial insufficiency, which is the most common reason for replants to fail during the early first 24 hours after surgery, was only associated with early failure,” Florczynski said. – by Casey Tingle

 

Reference:

Florczynski M, et al. Abstract 37. Presented at: American Society for Surgery of the Hand Annual Meeting; Sept. 5-7, 2019; Las Vegas.

 

Disclosure: Florczynski reports no relevant financial disclosures.