Multiple venous anastomoses decrease the need for intensive postoperative management in Tamai zone-I replantations.

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Multiple venous anastomoses decrease the need for intensive postoperative management in Tamai zone-I replantations.

Arch Plast Surg. 2017 Oct 27;:

Authors: Ryu DH, Roh SY, Kim JS, Lee DC, Lee KJ

Abstract
Background: Venous anastomosis is an important component of digital replantation but is not always feasible in all cases, which can require external bleeding to prevent or treat venous congested in the replanted tissue. Our study evaluates the relationship between number of vein anastomosis and survival rate for Tamai zone I replantations.
Methods: A retrospective review was performed for all patients who received replantation of fingertip amputation between 2014 and 2016. Patient charts were reviewed for demographic information, mechanism of injury, number of arterial and venous anastomoses, and for the use of anticoagulation, external bleeding, and/or leeches. The cohort was divided into three groups depending on the number of venous anastomosis: no vein (Group 1), a single vein (Group 2), and two or more veins (Group 3). Survival rates and external bleeding rates were analyzed across the groups.
Results: The review identified 143 fingertip replantations among 134 patients. Overall replant survival rate was 94% (135/143). Replant failures were due equally to venous complications (n=4, 50%) and to arterial complications (n=4, 50%) Our analysis did not identify any correlation between the number of veins anastomosed and replant survival rate (p = 0.689). However, increased number of anastomosis was associated with significantly lower frequency of external bleeding (p = 0.017).
Conclusions: The number of venous anastomosis did not correlated with survival rates. However, higher number of venous anastomosis was associated with decreased need for external bleeding, which can represent a significant decrease in the need for intensive postoperative monitoring and leech therapy.

PMID: 29076329 [PubMed - as supplied by publisher]