The Use of Microsurgeon Tool Box to Improve Outcomes in Avulsed Finger Replantation

Abstract

Background: Traumatic finger avulsion amputation considered one of the most challenging emergency procedure in the field of hand surgery. The good preparation of variable different situation that may be faced by the surgeon in that critical condition is important issue.Patients and methods: during the period from March 2020 to October 2023 in plastic surgery department, Ain Shams University, 17 cases were included in this prospective study presented with traumatic avulsion amputation of their finger underwent replantation. Different scenarios of the trauma necessitate the presence of different solutions. Results: This study was performed on 17 patients,11 males (64.7%) and 6 females (35.3%) with mean age (27.18 ± 14.16). Commonly involved finger was thumb (36.8%). Trauma by revolving machines in 13 cases (76.5%) and heavy blunt objects in 4 cases (23.5%). Average ischemia time were 3 hours of them 11 cases (64.7%) were cold ischemia and 6 cases (35.3%)were warm ischemia.Conclusion: The procedure of replantation of traumatic finger avulsion amputation has multiple difficulties to the hand surgeon. The surgical decision must be tailored according to the condition faced during surgery. An accepted final outcome can be achieved even in the most difficult scenario with good surgical preparation as regard both function and appearance.