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Secondary operations after replantation

D Pitzler, D Buck-Gramcko

    Annales Chirurgiae Et Gynaecologiae
    |January 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Secondary operations are common after upper limb replantation, with skin and nerve reconstructions being most frequent. Injury type, not age, influenced the need for further procedures, with slicing injuries requiring more than crush or saw injuries.

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    Area of Science:

    • Orthopedic Surgery
    • Reconstructive Surgery
    • Microsurgery

    Background:

    • Upper limb replantation aims to restore function after traumatic amputation.
    • Secondary operations are often necessary to optimize outcomes following initial replantation.
    • Understanding factors influencing secondary procedures is crucial for improving patient care.

    Purpose of the Study:

    • To evaluate the incidence and types of secondary operations after upper limb replantation.
    • To identify factors associated with the need for secondary procedures, including injury type, age, and level of amputation.
    • To analyze the relationship between vascular reconstruction and subsequent surgical interventions.

    Main Methods:

    • Retrospective evaluation of 104 secondary operations in 49 patients following 76 successful upper limb replantations.

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  • Analysis of 150 successful replantations in 106 patients to determine the overall incidence of secondary procedures.
  • Categorization of secondary operations by anatomical structure (skin, nerves, joints, bones, vessels) and injury type.

    • Main Results:

    • The incidence of secondary operations was 50.6% across 150 successful replantations.
    • Skin cover (28.5%) and nerve reconstructions (18.6%) were the most common secondary procedures.
    • Slicing injuries necessitated more secondary operations than circular saw or crush injuries, contrary to expectations.
    • Secondary operations were most frequent in patients aged 10-20, with no clear explanation provided.

    Conclusions:

    • Secondary operations are a significant aspect of upper limb replantation care, with specific procedures targeting skin and nerve deficits.
    • The type of injury is a more significant predictor of secondary procedures than previously assumed, with slicing injuries posing a higher risk.
    • The higher incidence of secondary procedures in younger patients warrants further investigation.