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Effects of hyperbaric oxygen on graft survival outcomes in composite grafting for amputated fingertip injury

  • Lee, Yoonsuk (Department of Emergency Medicine, Yonsei University Wonju College of Medicine) ;
  • Heo, Jae Won (Department of Plastic and Reconstructive Surgery, Yonsei University Wonju College of Medicine) ;
  • Moon, Jin Sil (Department of Biostatistics, Yonsei University Wonju College of Medicine) ;
  • Kim, Sug Won (Department of Plastic and Reconstructive Surgery, Yonsei University Wonju College of Medicine) ;
  • Kim, Jiye (Department of Plastic and Reconstructive Surgery, Yonsei University Wonju College of Medicine)
  • Received : 2020.03.13
  • Accepted : 2020.07.15
  • Published : 2020.09.15

Abstract

Background Fingertip injuries are the most common type of traumatic injury treated at emergency departments and require prompt and adequate interventions for favorable wound survival outcomes. Hyperbaric oxygen (HBO2) therapy is well known for its many positive effects on wound healing. We hypothesized that treatment with HBO2 would improve the graft survival outcomes of amputated fingertip injuries treated with composite grafts. Methods This retrospective observational study included fingertip amputations that were treated between January 2013 and December 2017. A conventional group and an HBO2 therapy group were statistically compared to evaluate the effect of HBO2 treatment. Graft survival was categorized as either success or failure. Results Among 55 cases (digits), 34 digits were conventionally treated, while 21 digits were treated with HBO2. No statistically significant differences were observed between the groups with regard to general characteristics. Among patients with guillotine-type injuries, the composite graft success rate was statistically significantly higher in the group that received HBO2 therapy than in the conventional group (P=0.0337). Overall, the HBO2 group also demonstrated a statistically significantly shorter healing time than the conventional group (P=0.0075). As such, HBO2 treatment facilitates composite graft survival in cases of fingertip injury. Conclusions HBO2 treatment was associated with an increased composite graft survival rate in guillotine-type fingertip injuries and reduced the time required for grafts to heal.

Keywords

References

  1. Sorock GS, Lombardi DA, Hauser RB, et al. Acute traumatic occupational hand injuries: type, location, and severity. J Occup Environ Med 2002;44:345-51. https://doi.org/10.1097/00043764-200204000-00015
  2. Fassler PR. Fingertip injuries: evaluation and treatment. J Am Acad Orthop Surg 1996;4:84-92. https://doi.org/10.5435/00124635-199603000-00003
  3. Ryu DH, Roh SY, Kim JS, et al. Multiple venous anastomoses decrease the need for intensive postoperative management in tamai zone I replantations. Arch Plast Surg 2018;45: 58-61. https://doi.org/10.5999/aps.2017.01018
  4. Chen SY, Wang CH, Fu JP, et al. Composite grafting for traumatic fingertip amputation in adults: technique reinforcement and experience in 31 digits. J Trauma 2011;70:148-53. https://doi.org/10.1097/TA.0b013e3181cc8553
  5. Koh SH, You Y, Kim YW, et al. Long-term outcomes of nail bed reconstruction. Arch Plast Surg 2019;46:580-8. https://doi.org/10.5999/aps.2019.00997
  6. Raurell A, Ahmed O, George E, et al. V-Y advancement flap and composite graft for alar-groove reconstruction. Br J Plast Surg 2002;55:8-11. https://doi.org/10.1054/bjps.2001.3730
  7. Hartman DF, Goode RL. Pharmacologic enhancement of composite graft survival. Arch Otolaryngol Head Neck Surg 1987;113:720-3. https://doi.org/10.1001/archotol.1987.01860070034011
  8. Aden KK, Biel MA. The evaluation of pharmacologic agents on composite graft survival. Arch Otolaryngol Head Neck Surg 1992;118:175-8. https://doi.org/10.1001/archotol.1992.01880020073018
  9. Fann PC, Hartman DF, Goode RL. Pharmacologic and surgical enhancement of composite graft survival. Arch Otolaryngol Head Neck Surg 1993;119:313-9. https://doi.org/10.1001/archotol.1993.01880150069010
  10. Henrich DE, Logan TC, Lewis RS, et al. Composite graft survival: an auricular amputation model. Arch Otolaryngol Head Neck Surg 1995;121:1137-42. https://doi.org/10.1001/archotol.1995.01890100049008
  11. Kadota H, Imaizumi A, Ishida K, et al. Successful local use of heparin calcium for congested fingertip replants. Arch Plast Surg 2020;47:54-61. https://doi.org/10.5999/aps.2019.00815
  12. Thom SR. Hyperbaric oxygen: its mechanisms and efficacy. Plast Reconstr Surg 2011;127 Suppl 1:131S-141S. https://doi.org/10.1097/PRS.0b013e3181fbe2bf
  13. Fodor L, Ramon Y, Meilik B, et al. Effect of hyperbaric oxygen on survival of composite grafts in rats. Scand J Plast Reconstr Surg Hand Surg 2006;40:257-60. https://doi.org/10.1080/02844310600907868
  14. Li EN, Menon NG, Rodriguez ED, et al. The effect of hyperbaric oxygen therapy on composite graft survival. Ann Plast Surg 2004;53:141-5. https://doi.org/10.1097/01.sap.0000112284.55035.aa
  15. Francis A, Baynosa RC. Hyperbaric oxygen therapy for the compromised graft or flap. Adv Wound Care (New Rochelle) 2017;6:23-32. https://doi.org/10.1089/wound.2016.0707
  16. Friedman HI, Fitzmaurice M, Lefaivre JF, et al. An evidence-based appraisal of the use of hyperbaric oxygen on flaps and grafts. Plast Reconstr Surg 2006;117(7 Suppl):175S-190S. https://doi.org/10.1097/01.prs.0000222555.84962.86
  17. Kim YS, Lee Y, Kim SJ, et al. Operation of a hyperbaric oxygen therapy center in Korea: report of our experience from a setting in its nascent stages. Undersea Hyperb Med 2019;46: 135-43.
  18. Lee DH, Mignemi ME, Crosby SN. Fingertip injuries: an update on management. J Am Acad Orthop Surg 2013;21:756-66. https://doi.org/10.5435/JAAOS-21-12-756
  19. Vincent JL, Abraham E, Moore FA, et al. Textbook of critical care. 7th ed. Philadelphia: Elsevier; 2017.
  20. Moon RE. Hyperbaric oxygen therapy indications. 14th ed. North Palm Beach: Best Publishing Company; 2019.
  21. Sebastin SJ, Chung KC. A systematic review of the outcomes of replantation of distal digital amputation. Plast Reconstr Surg 2011;128:723-37. https://doi.org/10.1097/PRS.0b013e318221dc83

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