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Case Reports
. 2021 Dec 10;9(12):e4016.
doi: 10.1097/GOX.0000000000004016. eCollection 2021 Dec.

Pulp De-epithelialization for Venous Outflow Augmentation after Digital Replantation

Erica Smearman  1 , Patricia Chan  1 , Paul A Ghareeb  1
Affiliations
Case Reports

Pulp De-epithelialization for Venous Outflow Augmentation after Digital Replantation

Erica Smearman et al. Plast Reconstr Surg Glob Open. .

Abstract

Traumatic amputation injuries account for a substantial portion of emergency department visits. This includes digital amputations that may be considered for replantation. Following surgery, venous congestion is the most common cause of replant failure. To address this, several methods have been proposed to augment venous outflow. In this article, a simple and straightforward method that can be utilized to establish or augment venous outflow in cases of venous insufficiency is described. This method entails de-epithelization of the replanted digit pulp skin with use of postoperative anticoagulation. The area can be further expanded or stimulated to increase bleeding as needed and is allowed to heal by secondary intention. This method allows for reliable venous outflow with relative ease of implementation.

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Conflict of interest statement

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Figures

Fig. 1.
Fig. 1.
Left thumb replantation after traumatic amputation, A, Pulp de-epithelialization with healthy bleeding from thumb pulp. B, Four weeks after surgery with healing of the de-epithelialization site.
Fig. 2.
Fig. 2.
Right index and middle finger zone I replantation A, Pulp de-epithelialization with bleeding from the finger tips. B, Four weeks after surgery with healing of the middle finger and status post amputation of the index finger.
See this image and copyright information in PMC

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