Predictors for Necrosis after Single Digital Replantation: a Retrospective Analysis of 946 Patients.

STUDY DESIGN: A retrospective study.

OBJECTIVE: Digital necrosis (DN) is a serious complication after replantation. However, predisposing factors, as reported less, remain controversial. The purpose of this study is to explore risk factors of necrosis after single digital replantation.

METHODS: Patients who underwent single digital replantations in our hospital between June. 2014 and October 2020 were included. We regarded DN as the failure group (FG) and digital survive as the success group (SG). The factors were conducted by univariate and multivariate analysis.

RESULTS: The survival rate in our study was 78.8% (745 of 946). The results of univariate analysis showed that there were significant differences in the levels of D-Dimer (1st), menstrual cycle, injury level, and starting and finishing time of surgery between different groups. In multivariate analysis, age, injury level, duration of surgery, and D-dimer (1 st) were identified as the risk factors for DN in the entire and male population. Additionally, regarding male patients, ischemia time was also found to be a risk factor for DN. In terms of female patients, the menstrual period and menopause were related to DN.

CONCLUSIONS: Many factors, including age, ischemia time, injury level, menstrual period, menopause, and duration of surgery, were related to DN after digital replantation. D-dimer (1 st) was first found as a predicted factor for DN. In addition, these results also showed that the starting and ending times of surgery were associated with DN by univariate analysis. Preoperative measures should be taken to lower the incidence of DN.