Digital Replantation Using Autogenous Vein Graft

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We carried out 107 replantations of amputated digits since last 1988. Among them, clean Gillotine amputation was 19 digits, mild crush amputation was 51 digits, severe crush amputation was 28 digits and avulsion type amputation was 9 digits. Vein grafts were used on 24 of these cases. The donor site of the vein graft was the volar aspect of the ipsilateral wrist or lower forearm. The average length of the vein graft was 1.8cm(1.0-3.0cm) and the average diameter of the vein graft was 1.5mm(1.0-2.0mm). Sixty-one of 107 digits were successfully replanted for an 57% success rate. The survival rate of the replantation using the vein graft was 66.7%. We analysed the functional results of the successfully replanted digits according to Nakamura and Tamai's criteria. The functional results of the replantated digits using vein graft were better than that of without using vein graft(more than fair results, 81.2% vs 73.3%). We conclude that the jucidious use of autogenous vein grafts in digital replantation surgery will improve the survival rate and promote the functional result.