Flying Solo: A Single Year-Single Surgeon Community Hospital Replantation/ Revascularization Experience

J. Scott Isenberg

doi:10.1055/s-2002-33318

Journal of Reconstructive Microsurgery, Table of Contents

J Reconstr Microsurg 2002; 18(6): 483-486
DOI: 10.1055/s-2002-33318

Flying Solo: A Single Year-Single Surgeon Community Hospital Replantation/ Revascularization Experience

J. Scott Isenberg

Department of Oral and Maxillofacial Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK

Abstract

ABSTRACT

A recent 12-month review of the emergent replantation/revascularization experience of a solo practice microsurgeon in a community hospital environment is presented. A total of 67 digits and/or hands/limbs were operated on in 51 patients with a success rate of 87 percent. There were nine failures, all in digits with crush-avulsion etiologies. These results support the position that the single microsurgeon practicing in a community hospital environment can provide levels of care for patients with amputated or devascularized digits and parts comparable to tertiary medical centers.

KEYWORDS

Replantation - revascularization - community hospital

Full Text

References

REFERENCES

1 Bieber E. Thumb avulsion: results of replantation and revascularization. J Hand Surgery . 1987; 12 786-789
2 Wilson C, Alpert B, Buncke H, Gordon L. Replantation of the upper extremity. Clin Plast Surg . 1983; 10 85-101
3 Malt R, McKhann C. Replantation of severed arms. JAMA . 1964; 198 716
4 Komaysu S, Tamai S. Successful replantation of a completely cut-off thumb. Plast Reconstr Surg . 1968; 42 374-377
5 May J, Toth B, Gardner M. Digital replantation distal to the proximal interphalangeal joint. J Hand Surg . 1982; 7A 161-166
6 Kleinert H, Jablon M, Tsai T. An overview of replantation and results of 347 replants in 245 patients. J Trauma . 1980; 20 390-397
7 Merle M, Dautel G. Advances in digital replantation. Clin Plast Surg . 1997; 24 87-105
8 Furnas D. Microsurgery and the community-based plastic surgeon. Clin Plast Surg . 1983; 10 145-148
9 Merle M, Dautel G. La Main Traumatique, L'Urgence. Paris Masson; 1992
10 Merle M, Dap F, Bour C. Digital replantation. In: Meyer V, Black M, eds. Microsurgical Procedures, Hand and Upper Limb, vol. 8 Edinburgh: Churchill, Livingstone 1991
11 Fukui A, Inada Y, Tamai S. Two methods for obtaining satisfactory results in digital replantation. Presented at the 26th Annual Meeting of the Japanese Society of Microsurgery, Tokyo, Japan, November, 1999
12 Furnas D, Salibian A, Achauer B. Genesis of a replantation program. Am J Surg . 1978; 136 21
13 Arai K, Toh S, Yasumara M, Tsubo K. Outcomes of replantation for single amputated digits. Presented at the 26th Annual Meeting of the Japanese Society of Microsurgery, Tokyo, Japan, November, 1999
14 McAuliffe J. The upper extremity trauma patient. Hand Clin . 1999; 15 187-191
15 Goldner R, Howson M, Belding N. One hundred thumb amputations: replantation versus revision. Microsurgery . 1990; 11 245-250
16 Foucher G, Norris R. Distal and very distal digital replantations. Br J Plast Surg . 1992; 45 199
17 Libermanis O, Krauklis G, Kapickis M. Distally-based forearm flow-through flaps for emergency finger revascularization. J Reconstr Microsurg . 2001; 17 607-610
18 Brandt K, Khouri R, Upton J. Free flaps as flow-through vascular conduits for simultaneous coverage and revascularization of the hand and digits. Plast Reconstr Surg . 1996; 98 321-327
19 Smith A, Bowen C, Rabczak T, Boyd J. Donor site deficit of the osteo-cutaneous radial forearm flap. Ann Plast Surg . 1994; 32 372-376
20 Goldberg J, Buncke H, Buncke G. Replantation of amputated parts. In: Georgiade G, Riefkohl D, Levin S, eds. Plastic, Maxillofacial and Reconstructive Surgery, 3rd edition Philadelphia: Williams & Wilkins 1997