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Related Experiment Videos

Fingertip replantation using the subdermal pocket procedure.

Tsan-Shiun Lin1, Seng-Feng Jeng, Yuan-Cheng Chiang

  • 1Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung Hsien, Taiwan. tslin.cgmh@msa.hinet.net

Plastic and Reconstructive Surgery
|January 7, 2004
PubMed
Summary

The subdermal pocket procedure offers a high success rate for fingertip replantation, especially for guillotine injuries. This method provides an alternative salvage technique when microsurgical replantation is not feasible.

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Area of Science:

  • Hand surgery
  • Reconstructive surgery
  • Microsurgery

Background:

  • Fingertip amputations pose challenges for restoring length and function.
  • Microsurgical replantation and composite graft techniques are established methods.
  • The subcutaneous pocket procedure serves as a salvage technique for composite grafts.

Observation:

  • The subdermal pocket procedure, a modification of the subcutaneous technique, was evaluated in 16 patients for 17 fingertip amputations.
  • Injuries included 8 guillotine and 9 crush types.
  • Revascularization involved 6 cases with arterial anastomosis and 11 with composite grafts.

Findings:

  • The subdermal pocket procedure achieved a 16 of 17 success rate.
  • Guillotine injuries had significantly higher success rates than crush injuries.

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  • Arterial anastomosis also showed a statistically significant difference in success rates compared to non-arterial methods.

    • Implications:

    • The subdermal pocket procedure offers advantages like precise contact, shorter healing times, and easier monitoring.
    • It presents a viable alternative salvage procedure for fingertip amputations lacking suitable vessels for microsurgery.
    • Functional outcomes included good range of motion and acceptable two-point discrimination in surviving fingertips.