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Digit replantation has undergone significant advancements since the 1960s. Despite progress, distal digit replantation remains one of the most challenging microsurgical procedures due to technical and clinical complexities. This review examines current challenges, strategic solutions in distal digit replantation, grounded in clinical experience and literature review. Key obstacles include managing minute vessel structures, venous congestion, and the critical condition of no available vessels for revascularization. Advances in surgical techniques, including preosteosynthesis vein grafting, intravascular stent, solitary central pulp artery bifurcation division, subdermal pocketing method, and postoperative management, have enhanced outcomes.
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http://dx.doi.org/10.1055/s-0045-1809651 | DOI Listing |
Semin Plast Surg
August 2025
Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Digit replantation has undergone significant advancements since the 1960s. Despite progress, distal digit replantation remains one of the most challenging microsurgical procedures due to technical and clinical complexities. This review examines current challenges, strategic solutions in distal digit replantation, grounded in clinical experience and literature review.
View Article and Find Full Text PDFMicrosurgery
September 2025
Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Background: Fingertip amputations are a common form of hand trauma and often require soft tissue reconstruction when replantation is not feasible. The reverse homodigital island flap (RHI) and the digital artery perforator flap (DAP) are two widely used techniques for fingertip reconstruction; however, direct comparisons of their clinical outcomes remain limited.
Methods: This retrospective study analyzed 39 patients who underwent either RHI (n = 20) or DAP (n = 19) procedures for fingertip injuries.
Plast Reconstr Surg
August 2025
From the Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School.
Ann Plast Surg
July 2025
From the Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN.
Escharotomies are incisions placed in burned, devitalized tissue to relieve tension caused by contraction and fluid shifts. In circumferential burns of the extremities and torso, escharotomy can be limb and lifesaving. Escharotomy of the fingers for salvage following full thickness burns is inadequately described in the literature of burn surgery.
View Article and Find Full Text PDFSisli Etfal Hastan Tip Bul
March 2025
Department of Anesthesia and Reanimation, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Objectives: Replantation surgery is one of the most difficult areas of reconstructive surgery. The aim of finger replantation is to restore sensation and adequate function of the amputated part in addition to restoring circulation. It is very crucial to investigate prognostic factors to improve the outcomes of this surgery.
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