Analysis of the risk factors that determine composite graft survival for fingertip amputation. (December 2018)

• Record Type: Journal Article
• Authors: Eo, SuRak; Doh, GyeongHyeon; Lim, SooA; Hong, Ki Yong
• Is Part Of: Journal of hand surgery. Volume 43:Number 10(2018)
• Page Start: 1030
• Page End: 1035
• Publication Date: 2018-12
• Subjects: Fingers -- amputation -- replantation -- transplantation -- microsurgery; 617.575059
• DOI: 10.1177/1753193418795820
• Languages: English
• ISSNs: 1753-1934

Abstract

The composite graft is the only surgical method that is able to maintain digital length and provide soft tissue coverage without donor site morbidities in microsurgically non-replantable fingertip amputations. This study aimed to explore the risk factors that determine the survival of composite grafts. Clinical characteristics associated with graft survival were retrospectively analysed by a comparison between the graft survival and failure groups. Of 94 patients who underwent a composite graft for fingertip amputation, the graft survived in 84 (89%). Surviving grafts showed reperfusion within 1 week. Multivariate analysis revealed that graft failure was independently associated with a crushing injury. Based on the risk factors from the comparison analyses and a review of previously published studies, a cutting injury, grafting the injured finger within 5 hours of injury, and being a non-smoker are associated with good results. In these circumstances, excellent outcomes with a high success rate can be achieved by composite graft in most adult patients as an alternative treatment to microsurgical replantation. Level of evidence: IV