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Current trends in digital replantation-a narrative review
Min Kai Chang1, Jin Xi Lim1, Sandeep Jacob Sebastin1
1Department of Hand and Reconstructive Microsurgery, National University Health System, Singapore, Singapore.
Annals of Translational Medicine
|August 9, 2024
Summary
Digital replantation is a standard care for traumatic amputation, but controversies remain regarding indications, anesthesia, and management. This review addresses these key issues to improve outcomes for digital replant patients.
Area of Science:
- Microsurgery
- Traumatology
- Reconstructive Surgery
Background:
- Digital replantation is standard for traumatic amputations.
- Advances in microsurgery have improved outcomes.
- Knowledge gaps and controversies persist in digital replantation.
Purpose of the Study:
- To review controversial aspects of digital replantation.
- To discuss current issues and unanswered questions.
- To consolidate strategies for challenging cases.
Main Methods:
- Narrative review of literature.
- Searched PubMed, Web of Science, and Google Scholar.
- Included articles on indications, anesthesia, vessel repair, vein grafting, and outcomes.
Main Results:
- Digital replantation survival rates are high.
- Microsurgical advancements push replantation boundaries.
- Strategies for venous outflow and vein grafting improve success.
Conclusions:
- Controversial areas include indications, contraindications, anesthesia, and postoperative management.
- Number of vessels repaired and injury mechanism impact survival.
- Further research is needed on vein anastomosis and thromboprophylaxis.
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