Fingertip Replantation without Venous Anastomosis

Abstract

We report our experience and results of fingertip replantation using the artery-only technique without vein or nerve repair. We performed a retrospective review of 18 patients who underwent fingertip replantation between 2013 and 2018. A total of 19 fingertips that were salvaged by microsurgical anastomosis of the digital arteries, but not digital veins, were included in this study. An incision of a few millimeters was made over the fingertip. None of the nail plate was removed and no medical leeches were used. The incision was scratched to maintain bleeding until physiological venous outflow was restored. Of 19 fingertips, 14 (73.7%) replanted fingertips survived. There were 5 replantation failures. Only one patient required blood transfusion. The survival rate in the present study was lower than that in previously reported studies with venous repair. If venous repair is not possible on the day of injury, salvation should be attempted within a few days.