Pre-operative predictive factors for the survival of replanted digits

Abstract

Purpose: The primary objective of this study was to evaluate factors that influence the survival rate after digit replantation.

Methods: A total of 291 digits of 200 patients who received digital replantation after complete amputation from 1 January 2014 to 31 December 2015 were included in this study. Univariate and multivariate analysis were performed to evaluate the correlation between potential risk factors and the failure rate. Age, gender, smoking status, Tamai level of amputation, causes of injury and ischemia time were recorded before replantation.

Results: Age, smoking, causes of injury and ischemia time were pre-operative predictors for survival. On the contrary, gender and Tamai level did not alter the survival rate significantly. We divided patients into four groups according their smoking status: none, mild (<10 cigarettes per day), moderate (10-20 cigarettes per day) and heavy (>20 cigarettes per day). Our data demonstrated that the risks of failure only increased in heavy group.

Conclusions: Mild and moderate cigarette consumption (<20 cigarettes per day) did not increase the risk for replant failure of digits. Heavy (>20 cigarettes per day) cigarette consumption, increased age (>45 years), non-cut injury and prolonged ischemia time (>12 hours) were risk factors for replant failure.

Keywords: Amputation; Digit; Replantation; Smoking.