Analysis of the factors affecting survival in digital replantation

Digital replantations were reported in literature commonly and have a high successful survival rate. However, in other cases, replantations were done hurriedly, and lives even endangered. How to improve the survival rate of replantation has become a rigorous problem faced by medical personnel. Our study was designed to investigate the influencing factors of survival in digital replantation. Consecutive patients with severed digital injury in our hospital between January 1, 2002, and December 31, 2013, were recruited for evaluating. The relationship of survival rate with baseline information, etiology of injury, ways of preservation, treatments and vascular crisis were evaluated using univariate and multivariate logistic regression analysis. 896 severed fingers were reviewed with the average age of 22.0±3.8 years and 851 (94.98%) fingers were succeeded with replantation. Univariate analysis demonstrated that many factors were correlated with success, such as ischemic time, the etiology of injury, age, plane of severed fingers, ways of preservation, artery reconstruction, platelet level, the incidence of vascular crisis (all P<0.05). Multivariate logistic regression analysis showed ischemic time, the etiology of injury, ways of preservation and the incidence of vascular crisis were the significant independent predictors for survival of replantation. Decreasing the ischemic time, preservation with freeze-dried, and prevention of vascular crisis were the key points of success of digital replantation. Given the importance of survival rates for the digital replantation, functional performance and economic status also should be monitored closely in clinical practice.