Objective: To examine the predictors influencing the graft survival rate after replantation in patients with digital amputations. Methods: We investigated the factors affecting the graft survival rate in 111 patients (131 digits) who underwent replantation after digital amputation between April 2010 and March 2016. Age, hypertension, diabetic status, smoking history, partial continuity status of the skin and hypodermal tissue of the amputated digit, level of amputation, and shape of amputation for engrafted and necrotized groups were compared. Results: Overall, 95 digits grafted successfully and 36 necrotized. The mean age in the necrotized group (46.1±16.3) was significantly older than in the engrafted group (39.7±14.6). The graft survival rate was 72.5%, and this was significantly higher in patients with clean-cut and blunt amputations than in those with crushing and avulsion amputations (86.3% vs 63.8%). It was also significantly higher when continuity of the soft-tissue was partially retained, compared with the absence of continuity (84.8% vs 65.9%). The lowest graft survival rate was for distal joint amputation (66.0%). Patients with hypertension, diabetes, and smoking history showed low graft survival rates. Conclusion: Age, soft-tissue non-continuity, crushing amputation, and avulsion amputation are predictors of poor outcome for graft survival.
