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A comparison between primary and secondary toe-to-hand transplantation
Kenneth K Yim1, Fu-Chan Wei, Chih-Hung Lin
1Department of Plastic Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taipei, Taiwan.
Plastic and Reconstructive Surgery
|June 29, 2004
Summary
Primary toe-to-hand transplantation offers comparable safety and efficacy to secondary reconstruction for crush and avulsion injuries. This approach may expedite patient recovery and return to work, warranting further comparative studies.
Area of Science:
- Microsurgery
- Reconstructive Surgery
- Hand Surgery
Background:
- Toe-to-hand transplantation is increasingly utilized for reconstructive purposes.
- The comparative safety and efficacy of primary versus secondary toe-to-hand transplantation remain under investigation due to limited comparative studies.
Purpose of the Study:
- To compare the safety and efficacy of primary versus secondary toe-to-hand transplantation for crush and avulsion injuries.
Main Methods:
- A retrospective review of 175 consecutive toe-to-hand transplantations (31 primary, 144 secondary) in 122 patients between August 1990 and December 1993.
- Follow-up ranged from 18 to 91 months (average 58 months).
- Outcomes analyzed included survival rates, anastomotic revisions, re-explorations, infections, and other complications.
Main Results:
- Survival rates were high and comparable: 96.8% for primary and 96.5% for secondary reconstructions.
- No statistically significant differences were found between primary and secondary groups in survival, intraoperative revisions, re-exploration, future procedures, infection rates, or complications.
- Primary toe-to-hand transplantation showed a lower superficial infection rate (0.7%) compared to secondary (6.5%).
Conclusions:
- Primary toe-to-hand transplantation is a safe and effective option for suitable candidates, yielding results comparable to secondary reconstruction.
- This approach has the potential to shorten the overall recovery and rehabilitation period, facilitating an earlier return to work.
- Further research is recommended to directly compare functional outcomes and return-to-work timelines between primary and secondary toe-to-hand transplantation.