External Bleeding Method in Zone I Replantation

Journal of the Korean Society for Surgery of the Hand 1996;1(1):117-125.
Published online January 1, 1996.

Seung Kyu Han,Byung II Lee,Woo Kyung Kim

Zone 1 수지접합술에 있어서 인위적 출혈요법의 유용성

한승규,이병일,김우경

Abstract

By virtue of the development of microvascular technique, amputated digits have been replanted as a routine procedure. Recently replantation of the amputated finger tip is emphasized because it can maintain digital length, provide adequate sensation, preserve the nail as well as provide good soft tissue coverage. But in many cases adequate venous repair is not possible due to unavailability of adequate vein in very distal part, severe soft tissue injury, or post-operative obstruction of repaired veins. For these cases we have used "salvage procedure" which consists of continuous external bleeding via a stab incision on paraungal area and dripping of heparinized saline solution at the incision site to maintain extemal bleeding. In addition systemic anticoagulants are given by heparinization with 3,000 IU heparin every 4 hours intravenously and by oral medication with acetylsalicylic acid. Duration of the procedure is between 5 to 14 days. From July 1985 to December 1994, 47 digits in 45 patients with complete amputation of finger tip(Zone I) were treated by our salvage procedure due to impossibility of venous repair or obstruction of repaired vein at the Korea University Guro Hospital. Overall survival rate of salvage procedure was 61.7%(29/47) Our patients were usually satisfied with the end result of the salvage procedure aesthetically and functionally.