Microvascular anastomoses in replanted fingers: do they stay open?

Area of Science:

• Microsurgery
• Vascular Surgery
• Diagnostic Imaging

Background:

• Finger replantation is a standard treatment for traumatic amputation.
• Functional outcomes of replanted digits are documented, but long-term microvascular anastomosis patency remains unclear.
• Assessing long-term patency is crucial for understanding the durability of digital replantation.

Purpose of the Study:

• To evaluate the long-term vascular patency of microvascular anastomoses in replanted fingers.
• To assess the utility of color-enhanced Duplex imaging for non-invasive evaluation of these anastomoses.
• To determine the durability of microvascular repairs in digital replantation over time.

Main Methods:

• Study included 18 patients with 24 replanted fingers, requiring a minimum 5-year follow-up.
• Color-enhanced Duplex imaging was utilized to assess vascular patency of microvascular anastomoses.
• Digital-Brachial Index was measured to evaluate vascular status.

Main Results:

• All evaluated microvascular anastomoses (n=24) were patent at a minimum of 5 years post-replantation, with some remaining open up to 11 years.
• 71% of replanted digits demonstrated a Digital-Brachial Index within normal limits.
• Color-enhanced Duplex imaging proved to be a non-invasive and accurate method for assessing long-term patency.

Conclusions:

• Microvascular anastomoses in replanted fingers exhibit excellent long-term patency.
• Color-enhanced Duplex imaging is a valuable tool for the non-invasive, long-term evaluation of microvascular procedures.
• These findings support the continued use and refinement of digital replantation techniques.