Suspended Replantation in Complete Amputations of the Hand and Finger

Cheon,  Ho Jun; Ahn,  Hee Chan; Kim,  Kyeong Chul; Woo,  Sang Hyun

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Journal of the Korean Society for Surgery of the Hand 2011;16(1):9-17.
Published online March 1, 2011.

Suspended Replantation in Complete Amputations of the Hand and Finger

Ho Jun Cheon, Hee Chan Ahn, Kyeong Chul Kim, Sang Hyun Woo

Kim & Woo's Institute for Hand Surgery & Reconstructive Microsurgery, W Hospital, Daegu, Korea. handwoo@hotmail.com

Abstract

Purpose
We report the results of replantations which was intentionally delayed for a certain period of time in patients with an amputation of multiple digits, both hands or the single digit presented at night. MATERIALS AND METHODS: Two staged intentianlly delayed replantations were performed in twenty patients. Three patients had amputations of four or more fingers, two had bilateral hand amputations and fifteen had a single digit amputation.

Results
The mean warm ischemic time was 3 hours and 58 minutes. The mean cold ischemic time was 2 hours and 36 minutes for the first operation, and 15 hours and 13 minutes for the second operation. Twenty digits out of 28 digits (85%) survived completely. At the mean follow-up of months, functional results according to Chen's criteria were rated as excellent in six patients, good in eight, and fair in five.

Conclusion
When the patients had multiple finger amputations, bilateral hand amputations or presented late at night, intentional delay of the replantation also provide satisfactory outcomes.

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