J Hand Microsurg 2020; 12(02): 085-094
DOI: 10.1055/s-0040-1701324
Review Article

Reporting Outcomes and Outcome Measures in Digital Replantation: A Systematic Review

Syena Moltaji
1   Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
,
Matteo Gallo
2   Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
,
Chloe Wong
2   Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
,
Jessica Murphy
3   Division of Plastic Surgery, McMaster University, Hamilton, Ontario, Canada
,
Lucas Gallo
3   Division of Plastic Surgery, McMaster University, Hamilton, Ontario, Canada
,
Daniel Waltho
3   Division of Plastic Surgery, McMaster University, Hamilton, Ontario, Canada
,
Andrea Copeland
3   Division of Plastic Surgery, McMaster University, Hamilton, Ontario, Canada
,
Marta Karpinski
2   Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
,
Sadek Mowakket
2   Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
,
Eric Duku
4   Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
,
Achilleas Thoma
3   Division of Plastic Surgery, McMaster University, Hamilton, Ontario, Canada
5   Department of Surgery, McMaster University, Hamilton, Ontario, Canada
6   Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
,
On Behalf of the McMaster University Plastic Surgery Core Outcome Sets & Measures Adapted to Surgery Working Group › Author Affiliations

Abstract

Introduction There is a lack of consensus on what the critical outcomes in replantation are and how best to measure them. This review aims to identify all reported outcomes and respective outcome measures used in digital replantation.

Materials and Methods Randomized controlled trials, cohort studies, and single-arm observational studies of adults undergoing replantation with at least one well-described outcome or outcome measure were identified. Primary outcomes were classified into six domains, and outcome measures were classified into eight domains. The clinimetric properties were identified and reported. A total of 56 observational studies met the inclusion criteria.

Results In total, 29 continuous and 29 categorical outcomes were identified, and 87 scales and instruments were identified. The most frequently used outcomes were survival of replanted digit, sensation, and time in hospital. Outcomes and measures were most variable in domains of viability, quality of life, and motor function. Only eight measures used across these domains were validated and proven reliable.

Conclusion Lack of consensus creates an obstacle to reporting, understanding, and comparing the effectiveness of various replantation strategies.

Supplementary Appendix



Publication History

Article published online:
09 April 2020

© .

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 
  • References

  • 1 U.S. National Library of Medicine. ClinicalTrials.gov. Glossary of Common Terms. Available at https://clinicaltrials.gov/ct2/about-studies/glossary. Accessed May 12, 2018
  • 2 Cho HE, Kotsis SV, Chung KC. Outcomes following replantation/revascularization in the hand. Hand Clin 2019; 35 (02) 207-219
  • 3 Sebastin SJ, Chung KC. Challenges in measuring outcomes following digital replantation. Semin Plast Surg 2013; 27 (04) 174-181
  • 4 Glasziou P, Chalmers I. Is 85% of health research really wasted? [blog post]. BMJ Opinion. Available at: https://blogs.bmj.com/bmj/2016/01/14/paul-glasziou-and-iain-chalmers-is-85-of-health-research-really-wasted/. Accessed May 12, 2018
  • 5 Williamson P, Altman D, Blazeby J, Clarke M, Gargon E. Driving up the quality and relevance of research through the use of agreed core outcomes. J Health Serv Res Policy 2012; 17 (01) 1-2
  • 6 Williamson PR, Altman DG, Bagley H. et al. The COMET Handbook: version 1.0. Trials 2017; 18 (Suppl. 03) 280-330
  • 7 Mowakket S, Karpinski M, Gallo L. et al. Reporting time horizons in randomized controlled trials in plastic surgery: a systematic review. Plast Reconstr Surg 2018; 142 (06) 947e-957e
  • 8 Clarke M. Standardising outcomes for clinical trials and systematic reviews. Trials 2007; 8: 39
  • 9 Zhang X, Yang L, Shao X, Wen S, Zhu H, Zhang Z. Use of a bilobed second dorsal metacarpal artery-based island flap for thumb replantation. J Hand Surg Am 2011; 36 (06) 998-1006
  • 10 Bellace JV, Healy D, Besser MP, Byron T, Hohman L. Validity of the Dexter Evaluation System’s Jamar dynamometer attachment for assessment of hand grip strength in a normal population. J Hand Ther 2000; 13 (01) 46-51
  • 11 Sollerman C, Ejeskär A. Sollerman hand function test. A standardised method and its use in tetraplegic patients. Scand J Plast Reconstr Surg Hand Surg 1995; 29 (02) 167-176
  • 12 Hurst NP, Kind P, Ruta D, Hunter M, Stubbings A. Measuring health-related quality of life in rheumatoid arthritis: validity, responsiveness and reliability of EuroQol (EQ-5D). Br J Rheumatol 1997; 36 (05) 551-559
  • 13 Dias JJ, Rajan RA, Thompson JR. Which questionnaire is best? The reliability, validity and ease of use of the Patient Evaluation Measure, the Disabilities of the Arm, Shoulder and Hand and the Michigan Hand Outcome Measure. J Hand Surg Eur Vol 2008; 33 (01) 9-17
  • 14 Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain 1983; 16 (01) 87-101
  • 15 Gummesson C, Ward MM, Atroshi I. The shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH): validity and reliability based on responses within the full-length DASH. BMC Musculoskelet Disord 2006; 7: 44-51
  • 16 Chen KK, Hsieh TY, Chang KP. Tamai zone I fingertip replantation: is external bleeding obligatory for survival of artery anastomosis-only replanted digits?. Microsurgery 2014; 34 (07) 535-539
  • 17 Su HH, Lui PW, Yu CL. et al. The effects of continuous axillary brachial plexus block with ropivacaine infusion on skin temperature and survival of crushed fingers after microsurgical replantation. Chang Gung Med J 2005; 28 (08) 567-574
  • 18 Povlsen B, Nylander G, Nylander E. Natural history of digital replantation: a 12-year prospective study. Microsurgery 1995; 16 (03) 138-140
  • 19 Isogai N, Fukunishi K, Kamiishi H. Patterns of thermoregulation associated with cold intolerance after digital replantation. Microsurgery 1995; 16 (08) 556-565
  • 20 Klein-Weigel P, Pavelka M, Dabernig J. et al. Macro- and microcirculatory assessment of cold sensitivity after traumatic finger amputation and microsurgical replantation. Arch Orthop Trauma Surg 2007; 127 (05) 355-360
  • 21 Wei CY, Orozco O, Vinagre G, Shafarenko M. Reverse distal transverse palmar arch in distal digital replantation. Ann Plast Surg 2017; 79 (05) 473-476
  • 22 Arata J, Ishikawa K, Sawabe K, Soeda H, Kitayama T. Osteosynthesis in digital replantation using bioabsorbable rods. Ann Plast Surg 2003; 50 (04) 350-353
  • 23 Dilek B, Gülbahar S, Bacakoğlu K. et al. Evaluation of bone mineral density after replantation or revascularization surgery in the upper extremity. Turk J Phys Med Rehabil 2011; 57: 73-79
  • 24 Alfeky H, McArthur P, Helmy Y. Salvaging digital replantation and revascularisation: efficiency of heparin solution subcutaneous injection. J Surg Res Pract 2018 2018; 1-6
  • 25 Dadaci M, Ince B, Altuntas Z, Bitik O, Uzun H, Bilgen F. A novel technique for distal fingertip replantation: polypropylene suture guided interpositional vein graft. J Plast Surg Hand Surg 2015; 49 (05) 280-283
  • 26 Foucher G, Norris RW. Distal and very distal digital replantations. Br J Plast Surg 1992; 45 (03) 199-203
  • 27 Matsuzaki H, Yoshizu T, Maki Y, Tsubokawa N. Functional and cosmetic results of fingertip replantation: anastomosing only the digital artery. Ann Plast Surg 2004; 53 (04) 353-359
  • 28 Daoutis N, Efstathopoulos D, Gerostathopoulos N. et al. Replantation of the thumb: survival rate and functional recovery in correlation with type of injury. Microsurgery 1993; 14 (07) 454-456
  • 29 Akyürek M, Safak T, Keçik A. Ring avulsion replantation by extended debridement of the avulsed digital artery and interposition with long venous grafts. Ann Plast Surg 2002; 48 (06) 574-581
  • 30 Yabe T, Tsuda T, Hirose S, Ozawa T. Treatment of fingertip amputation: comparison of results between microsurgical replantation and pocket principle. J Reconstr Microsurg 2012; 28 (04) 221-226
  • 31 Wagner ER, Bishop AT, Shin AY. Venous bridge arterial grafting for thumb replantation. Hand (N Y) 2017; 12 (03) 272-276
  • 32 Mihara M, Nakanishi M, Nakashima M, Narushima M, Gonda K, Koshima I. Distal phalanx replantation using the delayed venous method: a high success rate in 21 cases without specialised technique. J Plast Reconstr Aesthet Surg 2008; 61 (01) 88-93
  • 33 Nazerani S, Motamedi MH, Ebadi MR, Nazerani T, Bidarmaghz B. Experience with distal finger replantation: a 20-year retrospective study from a major trauma center. Tech Hand Up Extrem Surg 2011; 15 (03) 144-150
  • 34 Muneuchi G, Kurokawa M, Igawa K, Hamamoto Y, Igawa HH. Nonmicrosurgical replantation using a subcutaneous pocket for salvage of the amputated fingertip. J Hand Surg Am 2005; 30 (03) 562-565
  • 35 Mulders MA, Neuhaus V, Becker SJ, Lee SG, Ring DC. Replantation and revascularization vs. amputation in injured digits. Hand (N Y) 2013; 8 (03) 267-273
  • 36 Kim SW, Han HH, Jung SN. Use of the mechanical leech for successful zone I replantation. Scientific World Journal 2014; 2014: 10523
  • 37 Elliot D, Sood MK, Flemming AF, Swain B. A comparison of replantation and terminalization after distal finger amputation. J Hand Surg Eur Vol 1997; 22: 523-529
  • 38 Lukash FN, Greenberg BM, Gallico III GG, Panda M, May Jr JW. A socioeconomic analysis of digital replantations resulting from home use of power tools. J Hand Surg Am 1992; 17 (06) 1042-1044
  • 39 Erken HY, Takka S, Akmaz I. Artery-only fingertip replantations using a controlled nailbed bleeding protocol. J Hand Surg Am 2013; 38 (11) 2173-2179
  • 40 Aksoy A, Gungor M, Sir E. Fingertip replantation without and with palmar venous anastomosis: analysis of the survival rates and vein distribution. Ann Plast Surg 2017; 78 (01) 62-66
  • 41 Kwon GD, Ahn BM, Lee JS, Park YG, Ha YC. Clinical outcomes of a simultaneous replantation technique for amputations of four or five digits. Microsurgery 2016; 36 (03) 225-229
  • 42 Zamfirescu D, Salman M, Lascar I. Delayed venous repair for distal phalanx replantation. J Reconstr Microsurg 2012; 28 (09) 603-606
  • 43 Hoang NT. Microsurgical finger replantation in Hanoi, Vietnam: our first experience. Handchir Mikrochir Plast Chir 2005; 37 (05) 337-343
  • 44 Agarwal JP, Trovato MJ, Agarwal S, Hopkins PN, Brooks D, Buncke G. Selected outcomes of thumb replantation after isolated thumb amputation injury. J Hand Surg Am 2010; 35 (09) 1485-1490
  • 45 Nissenbaum M. A surgical approach for replantation of complete digital amputations. J Hand Surg Am 1980; 5 (01) 58-62
  • 46 Zhu H, Bao B, Zheng X. A comparison of functional outcomes and therapeutic costs: single-digit replantation versus revision amputation. Plast Reconstr Surg 2018; 141 (02) 244e-249e
  • 47 Tian Y, Li N, Wang LC, Ma J, Wang BS. A retrospective study of retrograde versus antegrade palm arteriovenous anastomosis in the distal fingertip replantation. Int J Clin Exp Med 2017; 10: 5349-5352
  • 48 Brown M, Lu Y, Chung KC, Mahmoudi E. Annual hospital volume and success of digital replantation. Plast Reconstr Surg 2017; 139 (03) 672-680
  • 49 Fukui A, Maeda M, Inada Y, Tamai S, Sempuku T. Arteriovenous shunt in digit replantation. J Hand Surg Am 1990; 15 (01) 160-165
  • 50 Kotani H, Kawai S, Doi K, Kuwata N. Automatic milking apparatus for the insufficient venous drainage of the replanted digit. Microsurgery 1984; 5 (02) 90-94
  • 51 Narushima M, Mihara M, Koshima I. et al. Intravascular stenting (IVaS) method for fingertip replantation. Ann Plast Surg 2009; 62 (01) 38-41
  • 52 Jeon BJ, Yang JW, Roh SY, Ki SH, Lee DC, Kim JS. Lateral nail fold incision technique for venous anastomosis in fingertip replantation. Ann Plast Surg 2016; 76 (01) 67-71
  • 53 Han D, Li QF. New technique for non-microsurgical reattachment of avulsed fingertips in adults. J Plast Surg Hand Surg 2010; 44 (4-5) 204-208
  • 54 Nishijima A, Yamamoto N, Yanagibayashi S. et al. The effect of smoking on necrosis rate in digital replantation and revascularization with prostaglandin E1 therapy: a retrospective study. Plast Reconstr Surg 2016; 138 (04) 848-853
  • 55 Lee CH, Han SK, Dhong ES, Kim HP, Kim WK. The fate of microanastomosed digital arteries after successful replantation. Plast Reconstr Surg 2005; 116 (03) 805-810
  • 56 Wang LH, Zhang GQ. Use of digital subtraction angiography for assessment of digital replantation. J Zhejiang Univ Sci B 2012; 13 (03) 209-212
  • 57 Kim KS, Eo SR, Kim DY, Lee SY, Cho BH. A new strategy of fingertip reattachment: sequential use of microsurgical technique and pocketing of composite graft. Plast Reconstr Surg 2001; 107 (01) 73-79
  • 58 Goel A, Navato-Dehning C, Varghese G, Hassanein K. Replantation and amputation of digits: user analysis. Am J Phys Med Rehabil 1995; 74 (02) 134-138
  • 59 Roh SY, Shim WC, Lee KJ, Lee DC, Kim JS, Yang JW. Short-term strength deficit following zone 1 replantations. Arch Plast Surg 2015; 42 (05) 614-618
  • 60 Ekerot L, Holmberg J, Niechajev I. Thumb replantation or not?. Scand J Plast Reconstr Surg 1986; 20 (03) 293-295
  • 61 Kwon GD, Ahn BM, Lee JS, Park YG, Chang GW, Ha YC. The effect of patient age on the success rate of digital replantation. Plast Reconstr Surg 2017; 139 (02) 420-426
  • 62 Chen J, Zhang AX, Chen QZ, Mu S, Tan J. Long-term functional, subjective and psychological results after single digit replantation. Acta Orthop Traumatol Turc 2018; 52 (02) 120-126
  • 63 Adani R, Marcoccio I, Castagnetti C, Tarallo L. Long-term results of replantation for complete ring avulsion amputations. Ann Plast Surg 2003; 51 (06) 564-568
  • 64 El-Diwany M, Odobescu A, Bélanger-Douet M. et al. Replantation vs revision amputation in single digit zone II amputations. J Plast Reconstr Aesthet Surg 2015; 68 (06) 859-863
  • 65 Zhang G, Ju J, Jin G, Tang L, Fu Y, Hou R. Replantation or revascularization for the treatment of hand degloving injuries. J Plast Reconstr Aesthet Surg 2016; 69 (12) 1669-1675
  • 66 Fujioka M, Hayashida K. Proximal interphalangeal replantation with arthrodesis facilitates favorable esthetics and functional outcome. J Trauma Manag Outcomes 2015; 9: 7
  • 67 Tessler O, Bartow MJ, Tremblay-Champagne MP. et al. Long-term health-related quality of life outcomes in digital replantation versus revision amputation. J Reconstr Microsurg 2017; 33 (06) 446-451
  • 68 Lithell M, Backman C, Nyström A. Cold intolerance is not more common or disabling after digital replantation than after other treatment of compound digital injuries. Ann Plast Surg 1998; 40 (03) 256-259
  • 69 Vaksvik T, Hetland K, Røkkum M, Holm I. Cold hypersensitivity 6 to 10 years after replantation or revascularisation of fingers: consequences for work and leisure activities. J Hand Surg Eur Vol 2009; 34 (01) 12-17
  • 70 Yu X, Pang L, Yang T, Liu P. Effects of vitamin B12 adjuvant therapy on neural recovery after replantation of severed fingers. Int J Clin Exp Med 2018; 11: 6228-6233
  • 71 McCabe SJ, Mizgala C, Glickman L. The measurement of cold sensitivity of the hand. J Hand Surg Am 1991; 16 (06) 1037-1040
  • 72 Wee HL, Li SC, Xie F. et al. Validity, feasibility and acceptability of time trade-off and standard gamble assessments in health valuation studies: a study in a multiethnic Asian population in Singapore. Value Health 2008; 11 (Suppl. 01) S3-S10
  • 73 Thoma A, McKnight LL. Quality-adjusted life-year as a surgical outcome measure: a primer for plastic surgeons. Plast Reconstr Surg 2010; 125 (04) 1279-1287