Patency Test of Vascular Anastomosis with Assistance of High-Speed Video Recording in Digit Replantation

Quality assessment of vascular anastomosis primarily depends on the experience of the treating surgeon. This highlights the need for an objective index. The main goal of our study was to establish a method of assessing the quality of vascular anastomosis in digit replantation. A total of 182 digits...

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Bibliographic Details
Published in:Journal of bone and joint surgery. American volume 2018-05, Vol.100 (9), p.729-734
Main Authors: Zhu, Hongyi, Zhu, Xiaozhong, Zhang, Changqing, Zheng, Xianyou
Format: Article
Language:English
Subjects:
Adult
Amputation, Traumatic - surgery
Anastomosis, Surgical - methods
Arteries - surgery
Female
Finger Injuries - surgery
Fingers - blood supply
Fingers - surgery
Humans
Male
Microsurgery
Middle Aged
Replantation - methods
Treatment Outcome
Vascular Patency
Veins - surgery
Video Recording - methods
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Summary:Quality assessment of vascular anastomosis primarily depends on the experience of the treating surgeon. This highlights the need for an objective index. The main goal of our study was to establish a method of assessing the quality of vascular anastomosis in digit replantation. A total of 182 digits from 141 patients were included in this study. The patients underwent replantation of completely amputated digits between June 1, 2015, and February 1, 2017. Patency tests of arterial and venous anastomoses were conducted for each replantation and recorded on digital video at 1,000 frames per second. We divided the study into 2 phases. In phase I (103 digits from 80 patients), we investigated whether the refilling velocity ratio (RVR) was associated with replantation failure. In phase II (79 digits from 61 patients), we adopted the RVR as a guiding parameter during surgery and compared the replantation success rate with that of the historical control of phase I. In phase I, ischemia time (>12 hours), arterial RVR (
ISSN:0021-9355
1535-1386
DOI:10.2106/JBJS.17.00494