Epidemiology of digital amputation and replantation in Taiwan: A population-based study

Abstract

Our study of the National Health Insurance database characterized the epidemiology of digital amputation patients undergoing replantation and the facilities in Taiwan where these procedures are performed. The hospitals treating more digital amputation patients had higher attempt rates and lower thumb failure rates.

Trends in Digital Replantation: 10 Years of Experience at a Large Canadian Tertiary Care Center: Les tendances de la replantation digitale : dix ans d’expérience d’un grand centre canadien de soins tertiaires

“…10,19 These are notably higher than Waikakul’s and Chang’s reports of 7% and 8% failure overall. 3,21 This discrepancy has been noted by other North American authors and is often ascribed to higher volume, specialized centers and different values that emphasize body integrity at Asian centers. 4 Chang et al and Liang et al certainly make a strong case for higher volumes in Taiwan; while American studies by Conn et al 28 and Gavrilova et al 29 estimated digital amputation incidence at 1.1 and 2.13 cases per 100 000 person-years, respectively, Chang et al 21 and Liang et al 30 cited figures of 10.2 and 12.5 per 100,000 person-years in Taiwan.…”

“…2,9 -11 Low compensation, waning surgeon experience, decentralization from high-volume hospitals, and a paucity of on-call hand specialists have all been implicated to explain the decline in replantations in the United States. 11,15,16,21 At our tertiary care center where a dedicated hand surgeon is always on call, the latter reason cannot be responsible for the downward trend, and the scope of this study does not allow for the assessment of the others in a Canadian context. It is certainly possible that the decline in patients treated with replantation is due to an increase in the number of patients who are treated with revision amputation only; because this study excludes such patients, it is not poised to demonstrate this.…”

Cost-effectiveness of Finger Replantation Compared With Revision Amputation

“…Probabilities of these complications are given in Table 1. 4,5,7,8,9,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33…”

“…Previous studies 4,5,6,7,8,9 have evaluated the clinical outcomes associated with replantation and revision amputation. However, there is a dearth of evidence on their cost-effectiveness.…”

Nerve wrap after end-to-end and tension-free neurorrhaphy attenuates neuropathic pain: A prospective study based on cohorts of digit replantation

“…The repair of vessels, nerves, tendons and bones of amputated digit is essential for the survival and functional recovery of replanted digit 1 – 3 . After the advance of microsurgery in decades, the survival rates of digital replantation have been reported up to 80% 4 , 5 . A satisfactory range of motion and appearance could also be restored by primary replantation and secondary surgeries, if necessary, in most cases 6 .…”