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Multiple venous anastomoses decrease the need for intensive postoperative management in tamai zone I replantations.

Deok Hyeon Ryu1, Si Young Roh1, Jin Soo Kim1

  • 1Department of Plastic Surgery, Gwangmyeong Sungae General Hospital, Gwangmyeong, Korea.

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Summary

More venous anastomoses in digital replantation did not improve survival rates but significantly reduced the need for external bleeding and related therapies. This finding impacts postoperative care strategies for fingertip replantations.

Keywords:
AmputationAnastomosisFingerReplantationVeins

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Area of Science:

  • Microsurgery
  • Reconstructive Surgery
  • Vascular Surgery

Background:

  • Venous anastomosis is crucial for digital replantation but not always feasible.
  • External bleeding is sometimes necessary to manage venous congestion in replanted digits.
  • The relationship between venous anastomosis count and replant survival requires further investigation.

Purpose of the Study:

  • To evaluate the correlation between the number of venous anastomoses and the survival rate of Tamai zone I digital replantations.
  • To assess the impact of venous anastomosis count on the requirement for external bleeding.

Main Methods:

  • Retrospective review of 143 fingertip replantations (2014-2016).
  • Patients categorized into three groups based on venous anastomoses: none, single, or two or more.
  • Analysis of survival rates, external bleeding, and leech therapy across groups.

Main Results:

  • Overall survival rate was 94% (135/143), with equal failures from venous and arterial complications.
  • No significant correlation found between the number of venous anastomoses and replant survival (P=0.689).
  • Increased venous anastomoses correlated with a significantly lower frequency of external bleeding (P=0.017).

Conclusions:

  • The number of venous anastomoses does not influence the survival rate of digital replantations.
  • A higher number of venous anastomoses is associated with a reduced need for external bleeding.
  • This suggests a potential decrease in the need for intensive postoperative monitoring and leech therapy.