title: Replantation of digits: a review of predictive factors for survival.
abstract: The survival of 75 consecutive digital replantations carried out between 2006 and 2010 at a regional hand centre in the United Kingdom was determined. The patient demographics, mechanism of injury, co-morbid factors, operative and post-operative details were extracted and reviewed from the medical and hand therapy notes. Predictive factors of survival were determined by using univariate and multivariate statistical analysis. The survival rate was 70%. Arterial thrombosis was the leading cause of replant failure, followed by venous congestion. Smoking, level of amputation, number of nerves repaired, warm ischaemia time and timing of replantation were independent predictors of replant survival. However, only warm ischaemia time less than 6 hours and 30 minutes and replantations done within 'office hours' showed significance on multivariate logistic regression. Our study suggests that replantations done in daylight hours, when feasible, with rested staff and a full complement of the theatre team are likely to have better outcomes.
  
  
  METHODS
  Level IV case series.
authors.affiliation: St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK ancabreahna@icloud.com.
authors.forename: A
authors.initials: A
authors.lastname: Breahna
authors.affiliation: St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK.
authors.forename: A
authors.initials: A
authors.lastname: Siddiqui
authors.affiliation: St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK.
authors.forename: E
authors.initials: E
authors.lastname: Fitzgerald O'Connor
authors.affiliation: St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK.
authors.forename: F C
authors.initials: FC
authors.lastname: Iwuagwu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000673:Amputation, Traumatic / Q000209:etiology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005383:Finger Injuries / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012092:Replantation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult
keywords: Replantation; amputation; digit; ischaemia; survival