gms | German Medical Science

Objectives/Interrogation: The purpose of this study was to analyze the surviving rates of of digital replantation after over 10 hours of intentional delay versus immediate replantation.

Methods: We reviewed the patients with digital replantation in our department treated between December 2017 and May 2018. These fingers were classified into three groups according to the time between injury and beginning of replantation: (1) within 5 hours after amputation; and (2) more than 10 hours. The fingers with delay of more than 10 hours were those of intentional delay for surgical replantation because operational rooms or surgical team were not available for earlier replantation surgery. The severed fingers were preserved in low temperature (about 4 degrees centigrade) for delayed replantation. We compared surviving rate of finger replantation in the two surgical groups.

Results: There were 15 fingers (13 patients) with immediate replantation within 5 hours after amputation. There were 37 fingers (30 patients) with intentional delay of finger replantation. The survival rate of the 15 fingers with immediate replantation was 93% with failure of one finger. The survival rate of the 37 fingers with intentional delay of finger replantation was 94.6% with failure in two fingers. Statistically, the difference in surviving rate not statistically significant (p < 0.05, Chi-square test).

Conclusions: We conclude from our data that intentional delay of finger replantation over 10 hours does not affect the surviving rate of digital replantation provided that the amputated parts were kept in low temperature. We suggest that replantation surgery can be routinely delayed without adverse influence to survival of the replantation when the surgical team or operation room are not readily available.