Replantation of a circumferentially degloved ring finger by venous arterializations

Wang, Xun; Ping, Zhang; Zhou, Youqing

doi:10.4103/0019-5413.114939

Cited by 4 publications

(8 citation statements)

References 10 publications

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“…Others have suggested vein arterialization as a valid approach to re-establish the blood supply of a degloved finger — as long as physiologic circulation restoration is not possible and veins in the degloved tissue are not damaged. [ 33 34 ]…”

Section: Introductionmentioning

confidence: 99%

The therapeutic challenges of degloving soft-tissue injuries

Latifi

Hennawy

El‐Menyar

et al. 2014

J Emerg Trauma Shock

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Background:Degloving soft-tissue injuries are serious and debilitating conditions. Deciding on the most appropriate treatment is often difficult. However, their impact on patients’ outcomes is frequently underestimated.Objectives: We aimed to study the incidence, clinical presentation, management and outcome of degloving soft-tissue injuries.Materials and Methods:We conducted a narrative traditional review using the key words; degloving injury and soft-tissue injuries through search engines PubMed, Science Direct, and Scopus.Results:There are several therapeutic options for treating degloving soft-tissue injuries; however, no evidence-based guidelines have been published on how to manage degloving soft-tissue injuries, although numerous articles outline the management of such injuries.Conclusion:Degloving soft-tissue injuries are underreported and potentially devastating. They require early recognition, and early management. A multidisciplinary approach is usually needed to ensure the effective rehabilitation of these patients.

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Section: Introductionmentioning

confidence: 99%

The therapeutic challenges of degloving soft-tissue injuries

Latifi

Hennawy

El‐Menyar

et al. 2014

J Emerg Trauma Shock

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“…Our past clinical experience in vein arterialization had revealed that process of revascularization can be lagging. 3 4 Based on this, we decided not to give up the replanted finger at the request of the patient. The finger did not become dark red until 9 h after the replantation.…”

Section: Resultsmentioning

confidence: 99%

“…Recently, as a remedial measure and an alternative to conventional replantation, vein arterialization has raised widespread interest in this area of the replantation surgery. 3 4 5 The unique characteristic of its nonphysiological blood supply requires special implementations through intraoperative vascular monitoring. Comprehending phenomenon will improve the success rate of this unusual replantation.…”

Section: Discussionmentioning

confidence: 99%

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The Reperfusion Delay in Finger Replantation by Vein Arterialization

Ping

Zhu

Xiao

et al. 2018

IJOO

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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.

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“…Sometimes it is impossible to perform an arterial anastomosis even with the interposition of a long venous graft [ 1 ]. Although the absence of anastomosed vessels constitutes a contraindication in replantation, the need for arterial vessels in good condition has recently been questioned in recent literature, where some authors have proposed the arterialization of veins with promising results [ 2 – 3 ]. However, this method of rescuing the amputated segments is not routine, and it is not clear what conditions can establish venous congestion [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluating Arterialized Vein in Thumb Replantation using Indocyanine Green Angiography: A Case Report

Costa,

Colonna,

Vindigni

et al. 2023

Am J Case Rep

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Patient: Male, 44-year-old Final Diagnosis: Amputated thumb Symptoms: Amputated thumb Clinical Procedure: — Specialty: Plastic Surgery • Surgery Objective: Unusual clinical course Background: The absence of valid vessels for the anastomosis constitutes a contraindication to replantation, but the need for arterial vessels in good condition has recently been questioned and some authors have proposed the arterialization of the veins with promising results. However, this method is not routine in replantation and it is unclear what conditions can establish venous congestion and loss of the replanted segment. Case Report: We detail a case where indocyanine green aids in evaluating arterialization of a vein during thumb replantation in a 40-year-old smoker following a crush injury. Multiple attempts to anastomose the princeps pollicis and its collateral vessel failed due to a thrombus formation, leaving the finger non-perfused despite urokinase treatment. To confirm the absence of reperfusion, we administered 0.3 mg/kg of indocyanine green through an upper limb peripheral vein. Observing no reperfusion, we located a suitable radial dorsal vein and performed an arteriovenous anastomosis at the proximal phalanx level. Indocyanine Green Angiography (IGA) revealed a slightly delayed reperfusion but a effective venous outflow. We did not consider it necessary to perform additional venous anastomoses other than the single dorsal radial venous anastomosis. Conclusions: This single case report shows the potential of indocyanine green as a valid aid to evaluate the perfusion of the replantation and also any early venous congestion, being able to modify the operative plan accordingly.

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Replantation of a circumferentially degloved ring finger by venous arterializations

Cited by 4 publications

References 10 publications

The therapeutic challenges of degloving soft-tissue injuries

The therapeutic challenges of degloving soft-tissue injuries

The Reperfusion Delay in Finger Replantation by Vein Arterialization

Evaluating Arterialized Vein in Thumb Replantation using Indocyanine Green Angiography: A Case Report

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