Revascularization of digits after prolonged warm ischemia

Four cases of digit revascularization after prolonged warm ischemia are presented. Amputation injuries occurred in the summer, with the average temperature above 23 degrees C. The average warm ischemia time was 24 hr (range: 20 to 30 hr) from injury to the time of establishment of arterial inflow. Complete survival was achieved in three cases and partial survival in one case. Previously, eight to ten hours were believed an acceptable limit for warm ischemia; however, this study indicates that successful revascularization is still possible, even after a much longer period of time.