Three-Year Activity Report of the Replantation Service for Amputation of the Hand in Poland

• Authors: Andrzej Żyluk , Jerzy Jabłecki , Leszek Romanowski , Agnieszka Mazur
• Languages of publication: EN

Abstracts

EN

A permanent on-call service for hand amputation (Replantation Service) was established in 2010 as the initiative of the Council of Polish Society for Surgery of the Hand. It is run by three qualified hand centres in Trzebnica, Poznań and Szczecin.The aim of the study was to present a summary of the almost three-year activity of this service.Material and methods. Over this period, a total of 435 cases of total amputations, subtotal amputations and other severe injuries to the hand were referred. Of these, 290 referrals (67%) were accepted and 141 (33%) rejected. Among accepted, there were 100 total (34%) and 113 subtotal (39%) amputations; 81 patients had other, severe hand injuries, such as crush, degloving and extensive wounds involving all tissues.Results. Young and middle-age males constituted the majority of patients with the mean age of 42 years (range 2-82). The most common injury was amputation of several digits (including thumbs) in one patient - 141 cases (48%), followed by amputations from the metacarpal- to the proximal forearm level -115 (39%) and elbow/arm level - 9 cases (3%). Niniteen patients (6%) had multi-level amputation or injury of the involved extremity. Replantation of the completely amputated extremity was performed in 83 patients (28%), revascularization in 95 (32%) and in 59 (20%) primary repair of the complex injuries. In 23 cases, the repair of tissue defects was performed with flaps, mostly with greater omentum. Survival rate was of 84% for replantations and 88% for revascularizations.Conclusion. Establishing of the Replantation Service constituted a significant progress in organization of the management of the most severest upper limb injuries.

Keywords

EN

hand replantation; microsurgery; outcome measurement

• Journal: Polish Journal of Surgery
• Year: 2012
• Volume: 84
• Issue: 11
• Pages: 574-581

Dates

published

1 - 12 - 2012

online

09 - 02 - 2013

Contributors

author

Andrzej Żyluk

• Department of General and Hand Surgery, Pomeranian Medical University in Szczecin

author

Jerzy Jabłecki

• Department of General Surgery, Replantation and Transplantation of the Limbs, St. Hedwig the Silesian Hospital in Trzebnica

author

Leszek Romanowski

• Department of Orthopaedics, Traumatology and Hand Surgery, Medical University in Poznań

author

Agnieszka Mazur

• Department of General and Hand Surgery, Pomeranian Medical University in Szczecin

References

• 1. Jabłecki J, Kaczmarzyk J, Kaczmarzyk L i wsp.. Problemy replantacji kończyn amputowanych na poziomie ramienia. Chir Narz Ruchu Ortop Pol 2004; 69: 9-13.
• 2. Żyluk A, Walaszek I: Ocena wyników replantacji kończyn górnych. Chir Narz Ruchu Ortop Pol 2007; 72: 165-73.
• 3. Gulgonen A, Ozer K: Long-term results of major upper extremity replantations. J Hand Surg 2012; 37E: 223-32.[WoS]
• 4. Leclere FM, Mathys L, Juon B et al.: Macroreplantations of the upper extremity: a series of 11 patients. Arch Orthop Trauma Surg 2012. doi.10.1007/s00402-012-1590.[Crossref]
• 5. Lindfors N, Raatikainen T: Incidence, epidemiology and operative outcome of replantation and revascularization of injury to the upper extremity. ScandJ Plast Reconstr Hand Surg 2010; 44: 44-49.[WoS]
• 6. Friedrich JB, Poppler LH , Mack CD et al.: Epidemiology of upper extremity replantation surgery in the United States. J Hand Surg 2012; 36A: 1835-40.[WoS]

Identifiers

DOI

10.2478/v10035-012-0095-z