title: Cooling Composite Graft for Distal Finger Amputation: A Reliable Alternative to Microsurgery Implantation.
abstract: BACKGROUND
  Finger amputations are the most common injuries to the upper limb. There are many options in the management of fingertip or finger amputations. We report our experience using cooling composite graft (Hirase technique) for distal finger amputation, as alternative to microsurgery implantation.
  
  
  METHODS
  We collected a case series of eight patients and report on the clinical outcomes after a 10-month follow-up period.
  
  
  RESULTS
  The amputated part survived almost completely in six patients; in these cases, the fingertip amputations were classified, according to the Allen classification, as level I in two cases, level II in three cases and level III in one case.
  
  
  CONCLUSIONS
  Re-implantation of an amputated finger with the Hirase technique is possible and can provide good distal soft-tissue coverage and recovery of sensory and motor functions. We believe that re-attachment of the amputated portion as a composite graft represents an important alternative to microsurgery.
authors.affiliation: Jalisco Plastic and Reconstructive Institute, University of Guadalajara, Guadalajara, Mexico.
authors.forename: Francesco
authors.initials: F
authors.lastname: Idone
authors.affiliation: Plastic Surgery Division, General and Specialist Surgery Department, University of Siena, Siena, Italy asisti6@gmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Sisti
authors.affiliation: Plastic Surgery Division, General and Specialist Surgery Department, University of Siena, Siena, Italy.
authors.forename: Juri
authors.initials: J
authors.lastname: Tassinari
authors.affiliation: Plastic Surgery Division, General and Specialist Surgery Department, University of Siena, Siena, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nisi
mesh_terms: D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D000714:Anastomosis, Surgical; D003080:Cold Temperature; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D012092:Replantation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Amputation; finger injuries; replantation methods; traumatic surgery; treatment outcome