CC-BY-NC-ND 4.0 · J Reconstr Microsurg Open 2018; 03(01): e25-e27
DOI: 10.1055/s-0038-1642627
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Digital Artery Massage for Improving Ischemia after Distal Digital Replantation Surgery

Yosuke Niimi*
Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
,
Hiroshi Ito*
Plastic and Reconstructive Surgery Division, Department of Surgery, University of Miyazaki Faculty of Medicine, Miyazaki-shi, Miyazaki, Japan
,
Karin Ikeda
Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
,
Miho Kirita
Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
,
Junji Hishiyama
Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
,
Hiroyuki Sakurai
Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

07 January 2018

05 March 2018

Publication Date:
24 April 2018 (online)

Abstract

Distal digital replantation is frequently associated with arterial thrombosis and/or spasm, leading ischemia in the replanted tissue. This report introduced a rescue technique for ischemia after distal digital replantation without reanastomosis. Two males, 64 and 51 years old, underwent Ishikawa subzone II finger amputations. Microsurgical replantations with vein grafts were performed. Intraoperatively, heparin and urokinase through intra-arterial infusion were given for one week. At 40 to 48 hours after surgeries, the replanted digits developed ischemia; massaging digital arteries at the proximal phalanx regions with running warm water was immediately initiated and ischemia was improved. In both cases, the replanted tissues were rescued, though a partial necrosis requiring full-thickness skin grafting was found in one case. This massage was easily, safely, and effectively performed without complications and was applicable in cases with ischemia after distal digital replantation, especially where reanastomosis was unfeasible.

Ethical Approval

This study was performed in accordance with the World Medical Association Declaration of Helsinki (June 1964) and subsequent amendments. The patients voluntarily gave written informed consent to participate in this study.


* Yosuke Niimi and Hiroshi Ito contributed equally to this report.