The Concept of Door-to-Surgery Time in Distal Digital Replantation
Journal of Korean Medical Science
; : e72-2018.
Article
in En
| WPRIM
| ID: wpr-764914
Responsible library:
WPRO
ABSTRACT
BACKGROUND: Digital replantation has become a well-established technique that has revolutionized hand surgery. One of the most important factors to a successful replantation is less than 12 hours of warm and 24 hours of cold ischemia time. The purpose of this article was to present a concept of door-to-surgery time and test the hypothesis that success in distal digital replantation is associated with this time. METHODS: Forty-five patients with 49 distal amputations were included in the study. Data regarding patient demographics, amputation characteristics, ischemia time, and surgical outcome were collected. Factors related to a successful replantation were analyzed. Fisher's exact test was used for statistical analysis. RESULTS: Type I, II, and III Yamano classification were noted in 11 (22.4%), 11 (22.4%), and 27 (55.1%) amputations. All the digits had arterial anastomoses while 19 (38.8%) digits were replanted without venous anastomosis. The mean door-to-surgery time was 229 minutes. The overall success rate was 77.6%. There were no differences in the survival rates between replantations with or without venous anastomosis. Patients with less than 180 minutes of door-to-surgery time had a significantly better survival rate compared to patients with greater time. CONCLUSION: The overall success rate was 77.6%. Patients with less than 180 minutes of door-to-surgery time had a significantly greater success rate (95.0%) compared to patients with longer door-to-surgery time (65.5%). Further effort must be made to achieve this goal in digital replantation.
Key words
Full text:
1
Index:
WPRIM
Main subject:
Replantation
/
Demography
/
Survival Rate
/
Classification
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Cold Ischemia
/
Hand
/
Amputation, Surgical
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Ischemia
Limits:
Humans
Language:
En
Journal:
Journal of Korean Medical Science
Year:
2018
Type:
Article