[Single digit replantations in ambulatory surgery. 85 cases].
The author performed 85 ambulatory digital replantations between 1994 and 1999. Ages varied from 15 to 33 (average 24), with a prevalence of the male sex. The main mechanism of injury was guillotine (60%), followed by avulsion (40%). Surgical procedure lasted approximately four hours. Patients remained in the hospital for eight hours maximum, period in which they were closely observed. Patients received printed instructions about the risks of arterial and venous thrombosis and how they could observe it themselves. A protocol was established to evaluate the results. Patients were instructed to call the surgeon as soon as any change--mainly in color--was noticed. Based on a phone call, twenty patients were evaluated in the immediate postoperative period (24 initial hours) to rule out circulatory problems. In fifteen patients, thrombosis was noted in the replanted segment. Twelve of these patients (14.11%) lost the replanted digit completely. The loss of the replanted segment was not observed in the group of patients that did not call the surgeon.
Braga-Silva
J
J
Service de chirurgie plastique, unité de chirurgie de la main et microchirurgie, Pontifícia universidade católica, Clinic SOS-Mão, Av. Ipiranga, 6690, conj. 216, centro clínico PUCRS, CEP: 90.610-000, Porto Alegre, Brazil. jeffmao@zaz.can.br
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000556:Ambulatory Surgical Procedures / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D000673:Amputation, Traumatic / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005383:Finger Injuries / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008866:Microsurgery / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000379:methods; D019990:Perioperative Care / Q000379:methods; D015995:Prevalence; D011446:Prospective Studies; D012092:Replantation / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D017678:Sex Distribution; D013997:Time Factors; D016896:Treatment Outcome