Digital Replantations: Comparison Veins Anastomoses first versus Arteries Anastomoses first

Abstract

Purpose This retrospective study analyses the effect performing veins anastomoses before arteries anastomoses in digital replantation.

Patients and methods 38 adult patients with replantation of 12 thumbs and 39 fingers, in whom the veins anastomoses were performed prior to the arteries anastomoses, were compared with 29 patients with replantation of 9 thumbs and 30 fingers, in whom the arteries anastomoses were done first, with respect to the survival rate, total active motion, grip strength, and duration of the replantation.

Results There was no significant difference between the two groups with respect to the survival rates, total active motion, and grip strength, while the duration of the replantation was significantly shorter in patients, in whom the veins anastomoses were performed prior to the arteries anastomoses (2 hours and 50 minutes versus 3 hours and 42 minutes; p < 0.001).

Conclusion Performing veins anastomoses before arteries anastomoses in digital replantations reduces the replantation time significantly without influencing the survival rate and the clinical outcome.

Zusammenfassung

Ziel Diese Retrospektive Studie untersucht die Auswirkungen der Umkehrung der Sequenz der Mikroanastomosen mit Durchfuhrung der Venenanastomosen vor den Arterienanastomosen bei Finger- und Daumenreplantationen.

Patienten und Methoden 38 erwachsene Patienten mit Replantation von 12 Daumen und 39 Fingern, bei denen die Venenanastomosen vor den Arterienanastomosen erfolgten, wurden bzgl. der Überlebensrate, der Grob- und Spitzgriffkraft, der Beweglichkeit und Dauer der Operation mit 29 Patienten mit Replantation von 9 Daumen und 30 Fingern verglichen, bei denen die Arterienanastomosen zuerst erfolgten.

Ergebnisse Während sich Überlebensrate, Grob- und Spitzgriffkraft sowie die Beweglichkeit der replantierten Finger und Daumen nicht signifikant unterschieden, war die Dauer der Operation bei Patienten, bei denen die Venenanastomosen zuerst durchgeführt wurden, signifikant kürzer als bei Patienten, bei denen die Arterienanastomosen zuerst erfolgten (2 h 50 min versus 3 h 42 min; p < 0,001).

Schlussfolgerung Erfolgen bei Finger- und Daumenreplantationen die Venen- vor den Arterienanastomosen, verkürzt dies signifikant die Operationsdauer, ohne Auswirkung auf die Überlebensrate und das klinische Ergebnis zu haben.

Key words

Digital replantation - venous anastomosis - arterial anastomosis - replantation time

Schlüsselwörter

Finger-und Daumenreplantationen - Venenanastomosen - Arterienanastomosen - Operationsdauer

Publication History

Received: 11 April 2021

Accepted: 21 July 2021

Article published online:
28 September 2021

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