Correlation between number of anastomosed vessels and survival rate in finger replantation

In replantation surgery, an attempt is made to repair as many vessels as possible. However, operative procedures might be simplified to reduce the operative time and the number of personnel required. In an attempt to determine the essential number of vascular anastomoses in finger replantation, the correlation between the number of anastomosed vessels and survival rates was examined in 216 replanted fingers that had been completely amputated. Digits with two arteries repaired had higher survival rates than those with only one artery repaired; however, there was no significant difference between survival rates and the number of arterial anastomoses in any of the zones. The number of anastomosed veins was well-correlated statistically with the survival rate. In Zone I (distal to the lunula), there was no significant difference in the survival rates between no venous anastomosis and one to two venous anastomoses. A statistically significant difference between the survival rates with one venous anastomosis and two or three venous anastomoses was observed only in Zone III (middle phalangeal region). These results support the following conclusions: 1) The essential amount of arterial repair appears to be one arterial anastomosis. 2) The essential venous repair appears to be no veins in Zone I, one vein in Zone II (lunula to distal interphalangeal joint), two veins in Zone III, and one vein in Zone IV (proximal phalangeal region).