Use of the mechanical leech for successful zone I replantation.

Abstract

Replantation of zone I finger injuries remains a challenge, particularly if the fingertip was previously scarred or atrophied, which makes it difficult to secure a suitable vein at the amputation site. In cases of artery-only anastomosis, we propose using a mechanical leech technique to maintain sufficient venous outflow until the internal circulation regenerates. We applied this procedure to eight patients who had zone 1 amputations without veins that were suitable for anastomosis. Emergent surgery was performed and an artery-only anastomosis was created. As there were no veins available, we cut a branch of the central artery and anastomosed it with a 24-gauge angioneedle, which served as a conduit for venous drainage. The overall survival rate for zone I replantation using mechanical leech was 87.5% and the average time to maintain the mechanical leech was 5 days. The mechanical leech technique may serve as an alternative option for the management of venous congestion when no viable veins are available.

• Authors: Sang Wha Kim, Hyun Ho Han, Sung-No Jung
• Journal: TheScientificWorldJournal (ScientificWorldJournal) Vol. 2014 Pg. 105234 ( 2014) ISSN: 1537-744X [Electronic] United States
• PMID: 24778578 (Publication Type: Journal Article)

Topics

• Adult
• Anastomosis, Surgical
• Female
• Finger Injuries (therapy)
• Fingers (blood supply, surgery)
• Humans
• Leeching (methods)
• Male
• Middle Aged
• Replantation (methods)
• Treatment Outcome