The Reperfusion Delay in Finger Replantation by Vein Arterialization

BACKGROUND: Extensive arterial damage of arteries that were too small in diameter precluded finger replantation. Venous arterialization in which arterial blood inflows through a proximal arterial-to-distal venous anastomosis, allows performing replantation that was previously considered as impossible and has resulted in a successful outcome. The aim is to introduce the distinctive phenomenon of the reperfusion delay in finger replantation by vein arterialization and to analyze its clinical significance. MATERIALS AND METHODS: In 2012–2015, vein arterialization was involved in 18 digits of 13 patients. The duration that the replants restore reperfusion following the release of tourniquet, defined as revascularization time, was recorded. RESULTS: The results showed that revascularization time ranged from 0 to 540 min, with an average of 54.5 min. The revascularization time was shorter than 20 min in 8 digits, between 20 and 120 min in 9 digits, and 540 min in one digit. CONCLUSION: The study findings have shown that reperfusion delay is usual during vein arterialization. Failing to understand it would result in the premature endings of the procedure. It is worth maintaining further observation, thus rescue otherwise possibly abandoned replantation.