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Subject Area

Plastic Surgery

Article Type

Original Study

Abstract

Objectives To evaluate the results of posttraumatic microvascular replantation/revascularization of crushed fingers and establish the prognostic factors that increase the success rate. Background Posttraumatic digital amputations are one of the most common injuries in emergency room (ER) that face plastic surgeons with a wide range of options for management. Optimization of the results after digital microvascular surgeries represents a challenge, especially in crushed and crushed-avulsion cases. Patients and methods A descriptive, retrospective study of 21 patients who underwent urgent replantation/revascularization digital surgery after crushed/crushed-avulsion injury in our center between January 2018 and March 2019. The data collected were classified into preoperative, intraoperative, postoperative, and follow-up data. The follow-up parameters were esthetic, sensory, and functional outcomes. The follow-up period extended to 1 year postoperative, every patient visited our outpatient clinic every 3 months for assessment of the results and data collection. Results During the period of the study, 21 patients of crushed fingers have been subjected to microvascular replantation/revascularization. The patients were 15 (71.4%) males and six (28.6%) females with mean age 27.7 years and their BMI ranged from 22 to 40. From 21 cases, there were 13 (61.9%) cases in which the injured finger totally survived, two (9.5%) cases show partial necrosis of the distal stump, and there were failure of anastomosis in six (28.6%) cases. Excellent esthetic outcomes were reported in 13 (86.5%) cases, while accepted or good outcomes were reported in five (33.3%) cases and poor results in only three (19.9%) cases (P = 0.013). Conclusions With taking great care to some important factors, the survival rate in crushed and crushed/avulsion is accepted with excellent long-term esthetic, functional, and sensory outcomes.

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