Success rate in replantation/revascularization digital surgery is one of the challenges of reconstructive surgery. For this reason, investigating prognostic factors for survival and improvement of outcomes is highly relevant. The goal of this study was to establish predictive factors of survival in replantation/revascularization digital surgery.
A descriptive, retrospective study was performed in patients who underwent urgent replantation/revascularization digital surgery in our center between January 2007 and July 2017. A total of 116 patients and 157 digits were included. Outcome (survival) factors evaluated were: preoperatively: age, sex, body mass index (BMI), ASA anesthesia score, comorbidities (smoking status, diabetes mellitus, hypertension), coagulation, type of lesion, number of affected digits, position of affected digits, injury mechanism, ischemia time; time between accident and the surgery; intraoperatively: anesthetic technique, fluid therapy (administered volume), length of surgery; and postoperatively: post-surgical complications, re-intervention requirements, surgical success rate. Statistical analysis was performed to evaluate outcome and elicit predictive factors.
157 digits from a total of 116 patients were included. Statistically significant differences regarding predictors of survival of replantation were found in ischemia time (0 0.003), length of surgery (p 0.004), post-surgical complications (p 0.000) and replantation need (p 0.000). The rest of analyzed variables were not statistically significant (p > 0.05). Revascularization surgery had a greater success rate than replantation (p 0.001).
Success rate in traumatic digital surgery is greater when revascularization surgery is performed, rather than replantation. Preoperative ischemia time, length of surgery, postoperative complications and re-intervention requirement are the factors that affect survival rate.
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The authors would like to thank Javier Martínez Cabañero and Cristian Hernández Delgado for their help with data collection.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors and there is no conflict of interest.
Conflict of interest
Ana Tejedor, Marina Vendrell and Carlos Puente declare that they have no conflict of interest. This manuscript, including related data, figures and tables has not been previously published and is not under consideration elsewhere. I attest to the fact that all authors listed on the title page have read the manuscript, attest to the validity and legitimacy of the data and its interpretation, and agree to its submission to Injury. I acknowledge that both I and the other authors have read the Instructions for Authors and agree with its contents. I acknowledge that if the enclosed manuscript is part of a larger whole or if the primary analysis has been previously published, this must be explicitly stated in the manuscript and the previous publication cited.
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Tejedor Navarro, A., Vendrell Jordà, M. & Puente Alonso, C. Digital replantation/revascularization: predictive factors to microsurgery success—a single-center study. Eur J Trauma Emerg Surg 47, 225–232 (2021). https://doi.org/10.1007/s00068-019-01226-x
- Survival rate