title: Risk factors for reexploration in toe-to-hand transfer: a multivariate analysis of 363 cases.
abstract: BACKGROUND
  Reexploration after toe-to-hand transfer increases the risk of failure. In this study, the authors aimed to identify risk factors for reexploration after toe-to-hand transfer.
  
  
  METHODS
  The medical records of 363 patients who underwent single toe-to-hand transfer between 2000 and 2010 were reviewed retrospectively. Patient demographics, clinical data, and operative data were collected, and multivariate analysis was performed.
  
  
  RESULTS
  Of these 363 patients, 299 toes (82.4 percent) had primary success in transplantation. Sixty-four toes required reexploration, of which seven toes failed. The overall success rate was 98.1 percent. Of the 64 toes that required reexploration, arterial spasm was found in 39 (60.9 percent), arterial thrombosis was found in 27 (42.2 percent), and venous thrombosis was found in 16 (25.0 percent). Multivariate logistic regression analysis revealed that postoperative wound infection, metacarpal hand injuries, and preceding flap coverage were independently associated with reexploration.
  
  
  CONCLUSIONS
  Reducing reexploration in toe-to-hand transfer may be facilitated by managing or avoiding these risk factors. Particular attention must be paid to avoid postoperative wound infection, which was the single greatest factor contributing to reexploration (adjusted OR, 12.6).
  
  
  METHODS
  Risk, III.
authors.affiliation: Taoyuan, Taiwan From the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine.
authors.forename: Yu-Te
authors.initials: YT
authors.lastname: Lin
authors.forename: Shiuan-Tzuen
authors.initials: ST
authors.lastname: Su
authors.forename: Steven
authors.initials: S
authors.lastname: Lo
authors.forename: Ching-Hsuan
authors.initials: CH
authors.lastname: Hu
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Lin
authors.forename: Fu-Chan
authors.initials: FC
authors.lastname: Wei
mesh_terms: D000328:Adult; D005260:Female; D006225:Hand / Q000098:blood supply / Q000601:surgery*; D006227:Hand Deformities, Acquired / Q000601:surgery; D006228:Hand Deformities, Congenital / Q000601:surgery; D006230:Hand Injuries / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control / Q000601:surgery*; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology; D014034:Toes / Q000098:blood supply / Q000637:transplantation*; D014182:Transplantation, Autologous; D016042:Transplantation, Heterotopic; D019737:Transplants / Q000098:blood supply; D055815:Young Adult