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J Hand Microsurg 2019; 11(03): 127-133
DOI: 10.1055/s-0039-1681981
Original Article
Society of Indian Hand & Microsurgeons

Characteristics of Secondary Procedures following Digit and Hand Replantation

Ashkaun Shaterian
1   Department of Plastic Surgery, University of California, Irvine, Orange, California, United States
,
Lohrasb Ross Sayadi
1   Department of Plastic Surgery, University of California, Irvine, Orange, California, United States
,
Amanda Anderson
1   Department of Plastic Surgery, University of California, Irvine, Orange, California, United States
,
Wendy K. Y. Ng
1   Department of Plastic Surgery, University of California, Irvine, Orange, California, United States
,
Gregory R. D. Evans
1   Department of Plastic Surgery, University of California, Irvine, Orange, California, United States
,
Amber Leis
1   Department of Plastic Surgery, University of California, Irvine, Orange, California, United States
› Author Affiliations Funding None.
Further Information

Publication History

Received: 17 September 2018

Accepted after revision: 27 December 2018

Publication Date:
25 February 2019 (online)

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Abstract

Introduction Secondary procedures following digit and hand replants are often necessary to optimize functional outcomes. To date, the incidence and characteristics of secondary procedures have yet to be fully defined.

Materials and Methods A literature search was performed using the NCBI (National Center for Biotechnology Information) database for studies evaluating secondary procedures following digit and hand replantation/revascularization. Studies were evaluated for frequency and type of secondary procedure following replantation. Descriptive statistical analysis was conducted across the pooled dataset.

Results Nineteen studies representing 1,485 replants were included in our analysis. A total of 1,124 secondary procedures were performed on the 1,485 replants. Secondary procedures most commonly addressed tendons (27.1%), bone/joints (16.1%), soft tissue coverage (15.4%), nerve (5.4%), and scar contractures (4.5%). A total of 12.7% of replants resulted in re-amputation (16.7% of secondary procedures). The details of secondary procedures are further described in the article.

Conclusion Secondary procedures are often necessary following hand and digit replants. Patients should be informed of the possible need for subsequent surgery, including delayed amputation, to improve hand function. These data improve our understanding of replant outcomes and can help patients better comprehend the decision to undergo replantation.

Keywords

digit and hand replantation - secondary procedure - traumatic amputation
 

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