Hand Surgeon Perspectives on Upper Extremity Allograft: A Survey of the American Society for Surgery of the Hand.

Abstract

Allograft tissue products have widespread applications across surgical specialties, but little data exist about surgeon attitudes toward the use of these products in the upper extremity. Using a web-based survey, we sought to investigate the use of and feelings toward allograft products among hand surgeons. A short questionnaire was distributed to all active members of American Society for Surgery of the Hand as of October 2015 (N=2,578). Demographic and practice setting information was collected. Additionally, questions concerning the use of human allograft tissue products of various types including bone, skin, and soft tissues were asked. Of 2,578 American Society for Surgery of the Hand members, 406 hand surgeons (15.8%) responded to the survey. A large majority (92%) reported having used allograft products in the upper extremity. Orthopedic-trained surgeons were more likely to have used bone and tendon allograft, whereas plastic and general surgery-trained surgeons were more likely to have used nerve and dermis allograft. Reduced donor site morbidity and complication rates were factors motivating surgeons to use allograft tissue. In spite of variation with respect to their use, allograft tissue products are popular and interest in new products, especially to improve flexor tendon pulley reconstruction, is high.