Ischemia Time up to 18 Hours Does not Affect Survival Rate of Replanted Finger Digits.

Park, Jung Il; Lee, Dong Chul; Kim, Jin Soo; Ki, Sae Hwi; Roh, Si Young; Yang, Jae Won

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2011;38(5):636-641.
Published online September 1, 2011.

Ischemia Time up to 18 Hours Does not Affect Survival Rate of Replanted Finger Digits.

Jung Il Park, Dong Chul Lee, Jin Soo Kim, Sae Hwi Ki, Si Young Roh, Jae Won Yang

Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital, Gyunggi-do, Korea. ophand@gmail.com

Abstract

PURPOSE
There are multiple dependent variables commonly attributed to survival of replanted digits. The ischemia time is thought to be a clinically relevant factor. However, controversy exists as large hand centers have reported successful replant outcomes independent of ischemic time. In this study, we present a single institution experience on the effect of ischemia time on the survival of completely amputated digits. METHODS: A retrospective review of a single institution experience was performed. This cohort included all comers who had suffered complete amputation of a digit (Zone 2-4) and underwent replantation from 2003 to 2009. Demographic information as well as injury mechanism, ischemic time, and replantation outcome were recorded for each patient. Chi-square was used to analyze the result.
RESULTS
Mean age was 35.5 years old(2-69). Mean replantation survival was 89.5%(37/317). Survival rates were 94, 88, and 88% in respective groups of 0~6, 6~12, of >12 hours of ischemia time. In chi-square analysis, there was no difference with p value of 0.257. No other independent patient factors showed statistically significant relationship to replant survival rate. In the group with longest ischemia time(12~18 hours) replant survival rate was 88% (37/42).
CONCLUSION
Prolonged ischemia time is commonly believed to be a contributing factor for replant survival. However, our experience has shown that survival rate is uniform up to 18 hours of ischemia.

Keywords: Ischemic time; Survival rate; Digit replantation; Single center