Natural history of digital replantation: a 12-year prospective study.
The purpose of the study was to evaluate the fate of the digital arterial anastomoses, resting total digit blood flow, and cold-induced discomfort following digital replantation with two repaired arteries. The evaluation was done with a Doppler ultrasound of the anastomoses, temperature recording from the finger pulp at room temperature, and a questionnaire regarding the patient's impression of cold-induced discomfort. At the 2-year follow-up all anastomoses were patent, but in two of the six patients one anastomosis was occluded at the 12-year follow-up. The replanted digits generally showed lower skin temperatures compared with controls at the 2-year follow-up but these had normalized 10 years later, even in digits with one of the two repaired arteries occluded. The number of patients with severe cold-induced discomfort was unchanged during the observation period.


CONCLUSIONS
The digital flow continues to increase after the first 2 years after replantation and may reach normal levels at room temperature; however, cold-induced discomfort is not normalized. Total blood flow improvement is not affected by late arterial occlusion.
Povlsen
B
B
Department of Hand and Plastic Surgery, University Hospital of Linköping, Sweden.
Nylander
G
G
Nylander
E
E
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D001158:Arteries / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005385:Fingers / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012039:Regional Blood Flow; D012092:Replantation; D012881:Skin Temperature; D018608:Ultrasonography, Doppler; D014654:Vascular Patency