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Review
. 2019 Nov;144(5):878e-911e.
doi: 10.1097/PRS.0000000000006134.

Practical Tips to Improve Efficiency and Success in Upper Limb Replantation

Sang Hyun Woo  1
Affiliations
Review

Practical Tips to Improve Efficiency and Success in Upper Limb Replantation

Sang Hyun Woo. Plast Reconstr Surg. 2019 Nov.

Abstract

Learning objectives: After reading this article, participant should be able to: 1. Describe the technique of replantation for very distal amputation of the digit and salvage procedures for venous drainage. 2. Perform single-digit replantation after viewing the videos. 3. Recognize appropriate cases for joint salvage techniques in periarticular amputation at each joint of the digit and wrist. 4. Outline the methods of flexor and extensor tendon reconstruction in an avulsed amputation of the digit or thumb. 5. Understand the order of digital replantation and transpositional replantation for a restoration of pinch or grip in multiple-digit amputation.

Summary: This article provides practical tips and caveats for the latest replantation surgical techniques for digit, hand, and upper extremity amputation. Four videos, clinical photographs, and drawings highlight important points of operative technique and outcomes of replantation.

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References

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    1. Hattori Y, Doi K, Ikeda K, Estrella EP. A retrospective study of functional outcomes after successful replantation versus amputation closure for single fingertip amputations. J Hand Surg Am. 2006;31:811–818.
    1. Lim R, Lee E, Lim J Jr, Chong AKS, Sebastin SJ, Foo A. External bleeding versus dermal pocketing for distal digital replantation without venous anastomosis. J Hand Surg Eur Vol. 2019;44:181–186.
    1. Aksoy A, Gungor M, Sir E. Fingertip replantation without and with palmar venous anastomosis: Analysis of the survival rates and vein distribution. Ann Plast Surg. 2017;78:62–66.
    1. Braig D, Thiele JR, Penna V, Stark GB, Eisenhardt SU. Results after distal digital replantation: Is it worth the effort? (in German). Handchir Mikrochir Plast Chir. 2017;49:29–36.

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