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573
Negative-Pressure Wound Therapy Application in Fingertip Replantations and a Systematic Review
Ching-Wei Hu1, Tommy Nai-Jen Chang1, Yi-Chieh Chen1
1From the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University; and Chicing Plastic Surgery Clinic.
Plastic and Reconstructive Surgery
|December 22, 2021
Summary
Negative-pressure wound therapy effectively manages venous congestion after fingertip replantation, achieving a high survival rate. This simple technique offers a promising salvage option for complex digital injuries.
Area of Science:
- Microsurgery
- Reconstructive Surgery
- Trauma Surgery
Background:
- Fingertip replantation presents significant technical challenges, with venous congestion being a primary cause of failure.
- Existing venous drainage and salvage techniques for venous congestion have limitations.
- Negative-pressure wound therapy (NPWT) shows promise but lacks extensive study in fingertip replantation.
Purpose of the Study:
- To identify risk factors associated with fingertip replantation outcomes.
- To assess the feasibility and clinical benefits of NPWT as a salvage technique for venous congestion in fingertip replantation.
Main Methods:
- A retrospective analysis of 27 patients (27 digits) undergoing fingertip replantation (Tamai zone I or II) between 2015 and 2019.
- Postoperative salvage NPWT was applied to manage venous congestion.
- Replantation data, including survival rates and clinical outcomes, were collected and analyzed.
Main Results:
- The overall survival rate for fingertip replantation using salvage NPWT was 92.6% (25/27 digits).
- The blood transfusion rate was 11.1% (3/27 digits).
- Average hospitalization was 8.04 days, with a median NPWT duration of 6 days.
Conclusions:
- Negative-pressure wound therapy is a straightforward and effective salvage method for venous congestion in fingertip replantation.
- NPWT demonstrates a satisfactory survival rate, a low need for blood transfusions, and contributes to shorter hospital stays.
