Download PDF
Handchir Mikrochir Plast Chir 2021; 53(05): 494-497
DOI: 10.1055/a-1276-1333
Case Report

Successful Replantation of Tamai Zone I Amputation with Delayed Vein Repair

Erfolgreiche Replantation einer Fingeramputation in Zone Tamai I mit verzögerter Venenanastomose
Burak Özkan 
Baskent University, Department of Plastic Reconstructive and Aesthetic Surgery
,
Ahmet Çagri Uysal
Baskent University, Department of Plastic Reconstructive and Aesthetic Surgery
,
Nilgün Markal Ertas
Baskent University, Department of Plastic Reconstructive and Aesthetic Surgery
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Zusammenfassung

Die Rekonstruktion digitaler Venen ist eine der schwierigsten Phasen der Endgliedreplantation. Distal lokalisierte digitale Venen haben ein kleines Gefäßkaliber und kollabierte Lumina, so dass sie nur schwer zu identifizieren und zu versorgen sind. Digitale Venen sind gelegentlich auch in den ersten Minuten nach der arteriellen Anastomose nicht erkennbar. In dieser Situation kann der Patient einige Stunden nach der Revaskularisierung erneut in den Operationssaal gebracht werden, um die dann erweiterten Venen sekundär zu rekonstruieren. Die verzögerte Rekonstruktion digitaler Venen ist eine zuverlässige und alternative Methode zur Replantation ohne Venennaht. In diesem Bericht wird eine erfolgreiche Replantation mit verzögerter Rekonstruktion digitaler Venen in der Tamai Zone I vorgestellt.

Abstract

Digital vein repair is one of the most challenging phases of distal phalanx replantation. Digital veins at very distal levels have a small vessel caliber and collapsed lumens, which makes them hard to identify and handle. Digital veins may not be visible immediately after arterial anastomosis. In this scenario, the patient can be taken to the operative room several hours after revascularization to visualize dilated and expanded veins for late digital vein repair. Late digital vein repair is a reliable and alternative method to artery only replantation. In this report, a successful replantation with late digital vein repair in Tamai Zone I is presented

Schlüsselwörter

Mikrochirurgie - Venenanastomose - Fingerendgliedreplantation

Key words

Microsurgery - vein repair - distal phalanx replantation


Publication History

Received: 16 May 2020

Accepted: 17 September 2020

Article published online:
21 January 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Lee BI, Chung HY, Kim WK. et al. The effects of the number and ratio of repaired arteries and veins on the survival rate in digital replantation. Ann Plast Surg 2000; 44: 288-294
    CrossrefPubMedGoogle Scholar
  • 2 Scheker LR, Becker GW. Distal Finger Replantation. J Hand Surg Am 2011; 36: 521-528
    CrossrefPubMedGoogle Scholar
  • 3 Gordon L, Leitner DW, Bunke HJ. et al. Partial nail plate removal after digital replantation as an alternative method of venous drainage. J Hand Surg Am 1985; 10: 360-364
    CrossrefPubMedGoogle Scholar
  • 4 Arami A, Gurevitz S, Palti R. et al. The Use of Medicinal Leeches for the Treatment of Venous Congestion in Replanted or Revascularized Digits. J Hand Surg Am 2018; 43: 949.e1-e5
    CrossrefPubMedGoogle Scholar
  • 5 Etöz A, Karaca K, Ozgenel Y. et al. Milking technique for reimplanted digits with insufficient venous drainage. Tech Hand Up Extrem Surg 2005; 9: 122-123
    CrossrefPubMedGoogle Scholar
  • 6 Akyürek M, Safak T, Keçik A. Fingertip replantation at or distal to the nailbed: use of the technique of artery-only anastomosis. Ann Plast Surg 2001; 46: 605-612
    CrossrefPubMedGoogle Scholar
  • 7 Lineaweaver WC, Hill MK, Buncke GM. et al. Aeromonas hydrophila infections following use of medicinal leeches in replantation and flap surgery. Ann Plast Surg 1992; 29: 238-244
    CrossrefPubMedGoogle Scholar
  • 8 Koshima I, Soeda S, Moriguchi T. et al. The use of arteriovenous anastomosis for replantation of the distal phalanx of the fingers. Plast Reconstr Surg 1992; 89: 710
    CrossrefPubMedGoogle Scholar
  • 9 Zhang X, Wen S, Wang B. Reconstruction of circulation in the fingertip without vein repair in zone I replantation. J Hand Surg Am 2008; 33: 1597-1601
    CrossrefPubMedGoogle Scholar
  • 10 Mihara M, Nakanishi M, Nakashima M. et al. 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: 88-93
    CrossrefPubMedGoogle Scholar
  • 11 Wu F, Shen X, Eberlin RK. et al. The use of arteriovenous anastomosis for venous drainage during Tamai zone I fingertip replantation/Injury, Int. J Care Injured 2018; 49: 1113-1118
    CrossrefPubMedGoogle Scholar
  • 12 Koshima I. Successful delayed venous drainage in 16 consecutive distal phalangeal replantations. Plast Reconstr Surg 2005; 115: 149-154
    CrossrefPubMedGoogle Scholar
  • 13 Morrison WA, McCombe D. Digital replantation. Hand Clin 2007; 23: 1-12
    CrossrefPubMedGoogle Scholar
  • 14 Kabakas F. Dorsal Approach for Vascular Repairs in Distal Finger Replantations. Microsurgery 2016; 36: 628-636
    CrossrefPubMedGoogle Scholar
  • 15 Smith DO, Oura C, Kimura C. et al. The distal venous anatomy of the finger. J Hand Surg Am 1991; 16: 303-307
    CrossrefPubMedGoogle Scholar
  • 16 Sebastin SJ, Chung KC. A systematic review of the outcomes of replantation of distal digital amputation. Plast Reconstr Surg 2011; 128: 723-737
    CrossrefPubMedGoogle Scholar
  • 17 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: 355-360
    CrossrefPubMedGoogle Scholar
  • 18 Schwabegger AH, Hussl H, Ninković MM. et al. Replantationen im Kindes- und Jugendalter. Langzeitergebnisse. Unfallchirurg 1997; 100: 652-657
    CrossrefPubMedGoogle Scholar