Our Strategy for Fingertip Amputation
Hiroshi Ito*, Mariko Mogaimi, Yumiko Nakajima and Hiroyuki Sakurai
Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan
- *Corresponding Author:
- Hiroshi Ito, MD, PhD
Tokyo Women’s Medical University Plastic and Reconstructive Surgery 8-1
Tokyo 162-8666, Japan
E-mail: [email protected]
Received date: August 18, 2015; Accepted date: September 21, 2015; Published date; September 28, 2015
Citation: Ito H, Mogaimi M, Nakajima Y, Sakurai H (2015) Our Strategy for Fingertip Amputation. Surgery Curr Res 5:250. doi:10.4172/2161-1076.1000250
Copyright: © 2015 Ito H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
From January 2005 to December 2008, we treated 59 patients with a total of 67 complete fingertip amputations. By statistically analyzing these 67 cases, we reported that up to subzone III (Ishikawa’s subzone), replanted fingertips could survive with arterial anastomosis alone, and we established a new treatment strategy.
1. For cases with amputation levels subzones I to III, arterial anastomosis was performed under digital block and venous anastomosis if possible. If the venous anastomosis was not performed, care was taken to relieve postoperative congestion. General anesthesia was used in cases where the patient had difficulty in staying still, such as a child.
2. For cases with amputation levels more proximal than subzone IV, both arterial and venous anastomoses were performed. Venous anastomosis is essential and considering the possibility of a vein graft, operations were performed either under axillary block or general anesthesia.
From July 2012 to November 2014, we treated 21 patients with 22 fingertip amputations according to the new treatment plan.
Results: Amputation levels were as follows: subzone I, 10 fingers; subzone II, 7 fingers; subzone III, 1 finger; and subzone IV, 4 fingers. Overall replantation success rate was 95% (21 out of 22 fingers). Conclusion: For the past two years, we have established a new treatment strategy for complete fingertip amputations, and obtained favorable outcomes. Depending on the situation of the patients and institutions, this strategy could become one of the treatment options.