Microsurgery of the Upper Extremity

Lerman, Oren Z.; Haddock, Nicholas T.; Elliott, River M.; Foroohar, Abtin; Levin, L. Scott

doi:10.1016/j.jhsa.2011.03.038

Cited by 16 publications

(14 citation statements)

References 113 publications

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“…No significant differences were observed for zones IeIII amongst group 1 and 2. While comparing group 3 with group 1, an increase in the risk of venous complications is observed when no vein is anastomosed; however, the statistical analysis was deemed not significant (RR 3.18, 95% CI [0.97, 10.42], P Z 0.0558). Comparison amongst zones IeIII did not reveal any significant differences either.…”

Section: Resultsmentioning

confidence: 94%

Impact of the number of veins repaired in short-term digital replantation survival rate

Efanov

Rizis

Landes

et al. 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Section: Resultsmentioning

confidence: 94%

Impact of the number of veins repaired in short-term digital replantation survival rate

Efanov

Rizis

Landes

et al. 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…Improvements in microvascular techniques and instruments [10,18], patient preferences [13,15], technical abilities, surgeon preferences, and available evidence also affect decision-making [8,16], which remains quite variable.…”

Section: Introductionmentioning

confidence: 99%

Replantation and Revascularization vs. Amputation in Injured Digits

Mulders

Neuhaus

Becker

et al. 2013

Hand (New York, N,Y.)

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Background The purpose of this study was to analyze factors associated with the decision to replant or revascularize rather than amputate an injured digit as well as factors associated with successful replantation or revascularization. Methods We reviewed 315 complete and subtotal amputations at or proximal to the distal interphalangeal joint in 199 adult patients treated over 10 years. Ninety-three digits were replanted (30 %), 51 were revascularized (16 %), and 171 were amputated (54 %), including 5 attempted replantations. Bivariate and multivariable analyses sought factors associated with replantation vs. amputation, revascularization vs. amputation, and success of replantation or revascularization. Results Factors associated with replantation rather than amputation were injury to the left hand, thumb, middle digit, and ring digit, more than one digit affected, and surgeon. Factors associated with revascularization are surgeon and shorter ischemia time. Forty-five replantations (48 %) and 41 revascularizations (80 %) were successful. Successful replantation was associated with the side of injury (left side more likely to survive), zone of injury (distal interphalangeal and interphalangeal joint more likely to survive and proximal phalanx less likely to survive), and shorter ischemia time. Success of revascularization was associated with the mechanism of injury (saw and not crush injury), multiple digits involved, and the surgeon. Conclusions The decision to replant, revascularize, or amputate a nonviable digit and the success of replantation and revascularization are related to both injury factors, such as mechanism of injury, affected digit, and zone of injury, and the surgeon.

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“…Based on these 3 factors, the surgeon will be able to determine whether a local pedicle flap will be sufficient or if a free flap will be necessary to cover the defect. 8 Tissue expansion in the upper extremity is often overlooked, yet it allows for improved tissue match, primary closure of donor sites, and decreased cost barrier compared with other microsurgical options. The capsule surrounding the expander can provide an ideal environment for tendon gliding.…”

Section: Clinical Factorsmentioning

confidence: 99%