Cargando…

The Concept of Door-to-Surgery Time in Distal Digital Replantation

BACKGROUND: Digital replantation has become a well-established technique that has revolutionized hand surgery. One of the most important factors to a successful replantation is less than 12 hours of warm and 24 hours of cold ischemia time. The purpose of this article was to present a concept of door...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Seong Hwan, Kim, Dong Wan, Hwang, Jae Ha, Kim, Kwang Seog
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Academy of Medical Sciences 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5811663/
https://www.ncbi.nlm.nih.gov/pubmed/29441741
http://dx.doi.org/10.3346/jkms.2018.33.e72
Descripción
Sumario:BACKGROUND: Digital replantation has become a well-established technique that has revolutionized hand surgery. One of the most important factors to a successful replantation is less than 12 hours of warm and 24 hours of cold ischemia time. The purpose of this article was to present a concept of door-to-surgery time and test the hypothesis that success in distal digital replantation is associated with this time. METHODS: Forty-five patients with 49 distal amputations were included in the study. Data regarding patient demographics, amputation characteristics, ischemia time, and surgical outcome were collected. Factors related to a successful replantation were analyzed. Fisher's exact test was used for statistical analysis. RESULTS: Type I, II, and III Yamano classification were noted in 11 (22.4%), 11 (22.4%), and 27 (55.1%) amputations. All the digits had arterial anastomoses while 19 (38.8%) digits were replanted without venous anastomosis. The mean door-to-surgery time was 229 minutes. The overall success rate was 77.6%. There were no differences in the survival rates between replantations with or without venous anastomosis. Patients with less than 180 minutes of door-to-surgery time had a significantly better survival rate compared to patients with greater time. CONCLUSION: The overall success rate was 77.6%. Patients with less than 180 minutes of door-to-surgery time had a significantly greater success rate (95.0%) compared to patients with longer door-to-surgery time (65.5%). Further effort must be made to achieve this goal in digital replantation.