Dataset Information

Defying standard criteria for digital replantation: A case series.

ABSTRACT:

Introduction

There is much controversy regarding the current indications and contraindications for digital replantation.

Presentation of case

Three patients with absolute contraindications for digital replantation according to classical criteria are presented (Case 1: multilevel amputation of the hand and fingers; Case 3: avulsion of the thumb; Case 4: index amputation proximal to the insertion of the flexor digitorum superficialis). In addition a patient with a very distal digital amputation (Case 2), whose indication for replantation is controversial is also presented. In all cases, the patients were replanted and showed good functional and aesthetical results.

Discussion

Most authors advocate that the classical indications for replantation have been validated by experience, are predicated on the potential for long-term function, and should be followed in most if not all cases. However, some surgeons have been adopting a more liberal attitude with good results.

Conclusion

The clinical cases presented in this paper suggest that the standard criteria for digital replantation should not be followed rigidly but instead should be regarded as a general guide.

SUBMITTER: Casal D

PROVIDER: S-EPMC3679422 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Publications

Defying standard criteria for digital replantation: A case series.

Casal Diogo D Gomez Manuel Macemino MM Antunes Paula P Candeias Henrique H Almeida Maria Angélica MA

International journal of surgery case reports 20130410 7

<h4>Introduction</h4>There is much controversy regarding the current indications and contraindications for digital replantation.<h4>Presentation of case</h4>Three patients with absolute contraindications for digital replantation according to classical criteria are presented (Case 1: multilevel amputation of the hand and fingers; Case 3: avulsion of the thumb; Case 4: index amputation proximal to the insertion of the flexor digitorum superficialis). In addition a patient with a very distal digita ...[more]

PMID: 23702366

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Project description:Background and objectiveDigital replantation for traumatic amputation has become the standard of care with advances in microsurgical techniques and technology. While digital replantation has progressed significantly, there are still gaps in knowledge in many aspects. Some of the controversial topics in digital replantation include the indications and contraindications, anesthesia, number of vessel anastomoses, mechanism of injury, role of vein graft, distal fingertip replantation, and postoperative management. This article is a narrative review that discusses these controversies and current issues pertaining to digital replantation.MethodsPubMed, Web of Science, and Google scholar were searched using keywords relating to "digit replantation", "amputation", and "digital replant" with the following terms: "indications", "contraindications", "anaesthesia", "survival", "vessels", "mechanism of injury", "vein graft", "outcome", and "thrombophylaxis". Relevant articles pertaining to digital replantation and deemed by the authors as current or controversial were included.Key content and findingsThe reported survival rates of digital replantation are high. With the advancement of microsurgical techniques and technology, the boundaries of digital replantation continue to be pushed. Various methods have been described recently to improve the success rates of difficult replants, such as strategies for venous outflow and vein grafting. However, there are still aspects of digital replantation that remain unanswered, such as the number of veins to anastomose and the thromboprophylaxis regime.ConclusionsThe review delves into controversial aspects of digital replantation, including contraindications, anesthesia, and postoperative management. Indications and contraindications will continue to evolve alongside advancements in microsurgical techniques and anesthesia. It highlights key factors influencing survival rates, such as the number of repaired vessels and the mechanism of injury. Finally, the review consolidates strategies for managing challenging digital replantations.

Dataset Information

Defying standard criteria for digital replantation: A case series.

Introduction

Presentation of case

Discussion

Conclusion

Publications

Defying standard criteria for digital replantation: A case series.

Similar Datasets

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