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J Plast Surg Hand Surg. 2015 Oct;49(5):280-283. doi: 10.3109/2000656X.2015.1041968. Epub 2015 May 4.

A novel technique for distal fingertip replantation: Polypropylene suture guided interpositional vein graft.

Author information

1
a 1 Department of Plastic, Reconstructive and Aesthetic Surgery, Meram Faculty of Medicine, Necmettin Erbakan University , Konya, Turkey.
2
b 2 Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Hacettepe University , Ankara, Turkey.
3
c 3 Clinic of Plastic, Reconstructive and Aesthetic Surgery, Elbistan State Hospital , Kahramanmaras, Turkey.

Abstract

BACKGROUND:

Despite current advances in microsurgery, fingertip replantation is still controversial, mainly due to its difficulty and cost. The purpose of this study is to describe a new technique of interposition vein graft guided by polypropylene suture in distal fingertip replantation.

METHODS:

A total of eight consecutive Tamai zone 1 fingertip replantations performed by the same author were included. All replantations were performed using interposition vein graft guided by polypropylene suture. This technique involved a vein graft of ∼ 2 cm, with appropriate calibration, obtained from the volar part of the forearm and a 2-0 polyprolene suture passed through the interposition vein graft. Then, a polypropylene suture guide carrying the vein graft was inserted into the artery. The anastomosis was easily performed with the aid of 10-0 or 11-0 nylon in a bloodless medium and without encountering the posterior wall problem.

RESULTS:

Average surgery time was 2.5 hours (range = 2-3 hours). Among eight Tamai zone 1 replantations, six were successful (75%). There were two replantations lost because of arterial failure.

CONCLUSION:

This technique may ease fingertip replantations and increase the success rate for Tamai zone 1 injuries.

KEYWORDS:

Fingertip replantation; interposition vein graft; polypropylene suture

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