Abstract
Distal digital replantation is frequently associated with arterial thrombosis and/or
spasm, leading ischemia in the replanted tissue. This report introduced a rescue technique
for ischemia after distal digital replantation without reanastomosis. Two males, 64
and 51 years old, underwent Ishikawa subzone II finger amputations. Microsurgical
replantations with vein grafts were performed. Intraoperatively, heparin and urokinase
through intra-arterial infusion were given for one week. At 40 to 48 hours after surgeries,
the replanted digits developed ischemia; massaging digital arteries at the proximal
phalanx regions with running warm water was immediately initiated and ischemia was
improved. In both cases, the replanted tissues were rescued, though a partial necrosis
requiring full-thickness skin grafting was found in one case. This massage was easily,
safely, and effectively performed without complications and was applicable in cases
with ischemia after distal digital replantation, especially where reanastomosis was
unfeasible.
Keywords
massaging - fingertip amputation - antithrombotic agent
