Preliminary observation on a modified postoperative therapeutic scheme following digit replantation

Abstract

Objective To observe the survival rate and incidence of vascular crisis following a modified postoperative treatment scheme for finger replantation and investigate the rationale and practicability of this scheme.Methods From February 2012 to May 2013,105 cases (129 digits) of single or double finger replantation were involved in the study.Among them 46 cases (55 digits) were treated with the modified postoperative therapeutic scheme.Low molecular weight dextran was not administered as part of the anticoagulant treatment.After 3 days of absolute bed rest,patients with stable blood perfusion of the replanted fingers were allowed to get up to eat and use the bathroom.They started ambulating in the hospital ward freely 5 days postoperatively.The other 59 cases (74 digits)were treated with the conventional postoperative scheme with regular anti-infection,anti-coagulation,anti-spasm therapy and absolute bed rest for 7 days.The occurrence of vascular crisis in all the patients was observed and recorded.The results of the two groups were compared statistically.Results The survival rates of replanted fingers between the modified therapeutic group(96.4％) and the conventional group (97.3 ％) were not significantly different (P ＞ 0.05).However,there was significant difference in the postoperative comfort scale(P ＜ 0.05).Conclusion The modified postoperative therapeutic scheme following finger replantation can shorten the length of postoperative bed rest and hospital stay,reduce bed rest associated complications,increase postoperative comfort while not decreasing the survival rate of replanted fingers.It is worth wider clinical application. Key words: Replantation; Finger injuries; Modify