Safety and Suitability of Finger Replantations as a Residency Training Procedure: A Retrospective Cohort Study With Analysis of the Initial Postoperative Outcomes

The objective of this study was to determine whether finger replantations constitute an appropriate and safe procedure for residency training. Additionally, the prognostic risk factors for the need to take a replanted finger back to the operation room and replant failure were analyzed. All patients who underwent finger replantation after complete amputation between 2007 and 2015 were included in a retrospective comparative study. These patients were either treated by an attending plastic surgeon (cohort 1) or by a postgraduate year 5 or 6 resident under supervision (cohort 2). Logistic regression analysis was used to identify the prognostic risk factors for emergent take backs and replant failures. A total of 109 completely amputated fingers were replanted in 89 patients. Fifty-seven digits were replanted in cohort 1, and 52 digits were replanted in cohort 2. Patient demographic data revealed an equal distribution between the two cohorts with an overall finger-replantation success rate of 67.0%. The prognostic risk factors related to increased take back and replant failure rates were fewer than two venous anastomoses (take back odds ratio [AOR], 0.27; confidence interval (CI), 0.12–0.63; and replant failure AOR, 0.21; 95% CI, 0.08–0.55) and intraoperative noticeable problems regarding the vascular anastomoses (take back AOR, 2.26; 95% CI, 0.96–5.33 and replant failure AOR, 2.45; 95% CI, 1.00–6.00). The type of surgeon did not exhibit an influence on the risk of take...
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Microsurgery Source Type: research