A Novel Solution for Venous Congestion Following Digital Replantation: A Proximally Based Cross-Finger Flap

Zhao, Jinmin; Abdullah, Shalimar; Li, Wen Jun; Appukuttan, Aswin; Tien, Huey

doi:10.1016/j.jhsa.2011.04.013

Cited by 16 publications

(9 citation statements)

References 17 publications

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“…23,29 A study of cross-finger flaps for the treatment of venous congestion following digit replantation used the Aesthetics domain along with the Pain domain. 30 Only 4 studies used the MHQ as the sole outcome measure. Virtually all other studies include functional measures, such as strength or motion or radiographic measures, and many included additional subjective measures, most frequently the SF-36.…”

Section: Resultsmentioning

confidence: 99%

The Michigan Hand Outcomes Questionnaire after 15 Years of Field Trial

Shauver

Chung

2013

Plastic and Reconstructive Surgery

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Background The Michigan Hand Outcomes Questionnaire (MHQ) has been used to assess a variety of hand and upper extremity injuries and conditions for nearly 15 years. It has been included in several overviews of upper extremity outcomes measures, but it has not been systematically examined regarding its clinimetric properties during field trials. Methods We conducted a review of the MHQ in the English language literature from 1998 through March 2012. Data from clinical studies were abstracted and compiled. Results The MHQ has been used in 58 clinical studies and its clinimetric properties have been analyzed in an additional 18 publications. The MHQ compares favorably with other hand outcomes instruments in the areas of test-retest reliability, validity, and responsiveness. High internal consistency may indicate redundancy within the items in the MHQ. The strength of the MHQ is its multidimensional construct in measuring patient-rated outcomes in symptom, function, aesthetics, and satisfaction. Conclusions The MHQ has been applied across a variety of conditions affecting the hand and upper limb. Its psychometric properties have been tested through field trials in various clinical settings around the world. Level of Evidence Systematic Review; Level II

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Section: Resultsmentioning

confidence: 99%

The Michigan Hand Outcomes Questionnaire after 15 Years of Field Trial

Shauver

Chung

2013

Plastic and Reconstructive Surgery

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“…Ultimately, several options exist, including anastomotic revision, interposition vein grafting, and nonsurgical modalities (leech therapy, heparin-induced bleeding, systemic anticoagulation, etc.). 15,25,29,30,38 To date, there has not been a thorough investigation on their efficacy in secondary revascularization. In our study, we found that replants complicated by venous compromise had higher survival rates if managed with interposition vein grafts (vs. vein revision and nonsurgical modalities).…”

Section: Discussionmentioning

confidence: 99%

“…Some studies indicate that arterial insufficiency is a common cause for digit replantation failure, [11][12][13][14] whereas others cite venous issues. 9,[15][16][17][18][19][20][21] Furthermore, the optimal treatment modality following vascular compromise is not well described in the literature. Ultimately, a better understanding of the incidence, etiology, and survival rates following vascular compromise after replantation can help guide decision-making and improve outcomes following amputation.…”

Section: Introductionmentioning

confidence: 99%

Etiology and Survival of Secondary Revascularizations after Hand and Digit Replantations

Shaterian¹,

Sayadi²,

Anderson³

et al. 2020

Journal of Hand and Microsurgery

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Objective Hand and digit replantations can be complicated by vascular insufficiency necessitating revision of the original replantation. To date, few studies have evaluated outcomes in secondary revascularizations following replantation. Therefore, the objective of this study was to evaluate the incidence, etiology, and survival rates following secondary revascularization after hand and digit replantations. Materials and Methods A literature search was performed on NCBI for studies documenting secondary revascularization procedures following hand and digit replant. Studies were evaluated for the etiology of vascular failure, frequency of secondary revascularization, and survival rates following intervention. Statistical analysis was conducted across the pooled dataset. Results A total of 16 studies including 1,192 amputations were analyzed. We found that 16.9% (201/1,192) of replants were complicated by vascular compromise. The frequency of vascular compromise was not statistically different between arterial and venous etiologies. The survival rate following secondary revascularization was 55.6%, with no significant difference between the arterial and venous groups. Secondary arterial revascularization was often treated with arterial revision (nine of nine studies) and/or with vein grafting (two of nine studies). Secondary revascularization for venous insufficiency resulted in different survival rates for nonsurgical modalities (58%) versus vein revision (37.5%) versus vein grafting (100%). Conclusion Survival rates following secondary revascularization are lower; however, they may be improved using vein grafts following venous insufficiency. These data can be used to better understand the etiology of replant failure and guide decision-making.

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“…With the rapid development and perfection of microsurgical technique, gradual maturity of small vascular anastomosis technique in clinical medicine and the increasingly higher requirement of people for modern life quality, people have had higher and higher requirements of severed finger replantation due to the serious impact of severed finger on the appearance, function, psychology and normal communication of patients ( 9 , 10 ). Therefore, it was found in clinical medicine on the basis of body anatomy that there are direct communicating branches between the branch and vein of dorsal digital artery, and it is difficult for the corresponding supply of finger blood to return through the vein when the physiological reflux veins disappear ( 11 ); but the proximal digital arterial ligation after one-side anastomosis can reduce the arterial blood perfusion of the replanted finger to a certain extent, buffer the venous return load, and form a new blood circulation from the dorsal digital arterial branches to the dorsal digital veins ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Unilateral digital arterial ligation combined with low molecular weight heparins in severed finger without venous anastomosis

et al. 2018

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Curative effect of unilateral digital arterial ligation combined with low molecular weight heparins in the treatment of severed finger without venous anastomosis and its influence on venous crisis was studied. A total of 80 patients with distal severed finger treated in Wuxi No. 9 People's Hospital from May 2014 to July 2016 were selected into the study. According to the random number table, they were divided into the control group (n=40) and the research group (n=40). The patients in control group were treated with unilateral digital arterial ligation, while the patients in research group were treated with unilateral digital arterial ligation combined with low molecular weight heparin. The wound healing time after operation, hospitalization time, hemorheology detection results, survival rate and necrosis rate of replanted finger, incidence rate of venous crisis and recovery effect of replanted finger were compared between the two groups. After operation, the wound healing time and hospitalization time of patients in research group were lower than those in control group, and the differences were statistically significant (p<0.05). At 72 h after operation, the platelet adhesion rate, whole blood viscosity, whole blood low-shear viscosity, hematocrit and fibrinogen level in patients in research group were lower than those in control group, and the differences were statistically significant (p<0.05). At 7th day after operation, the survival rate of replanted finger in the research group was higher than that in control group, but the necrosis rate of replanted finger and incidence rate of venous crisis were lower than those in control group, and the differences were statistically significant (p<0.05). At 6 months after operation, the nail length, sensation, two-point discrimination and mobility of distal interphalangeal joint of patients in the research group were superior to those in control group, and the differences were statistically significant (p<0.05). Unilateral digital arterial ligation combined with low molecular weight heparin has a significant effect in the treatment of severed finger without venous anastomosis, which can effectively reduce or prevent the occurrence of venous crisis, improve the survival rate of replanted finger and promote the function recovery of replanted finger, so it is worthy of clinical promotion.

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A Novel Solution for Venous Congestion Following Digital Replantation: A Proximally Based Cross-Finger Flap

Cited by 16 publications

References 17 publications

The Michigan Hand Outcomes Questionnaire after 15 Years of Field Trial

The Michigan Hand Outcomes Questionnaire after 15 Years of Field Trial

Etiology and Survival of Secondary Revascularizations after Hand and Digit Replantations

Unilateral digital arterial ligation combined with low molecular weight heparins in severed finger without venous anastomosis

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