Purpose
The purpose of this study was to determine if the use of postoperative therapeutic
dose intravenous heparin (POTDIVH) was indicated in digital replantation and revascularization
by assessing digit survival and complications associated with heparin.
Methods
All patients with amputation distal to the carpal tunnel treated at our center from
2004 to 2020 were included for chart review. Digit survival and complication rates
were compared between patients who received POTDIVH (group A) and those who did not
(group B). Logistic regression analysis and subgroup analysis were conducted.
Results
A total of 795 patients (1,155 digits) were included in this study (248 patients/374
digits in group A and 547 patients/781 digits in group B). The overall revascularization
and replantation success rate was 79.9% in the POTDIVH group and 92.8% in the non-POTDIVH
group. In our retrospective regression and subgroup analyses, group A demonstrated
increased odds of failure compared with group B and was associated with increased
bleeding-related complications. Subgroup analyses stratified by the mechanism of injury
and vein grafting also showed a significantly decreased survival in the POTDIVH group.
Conclusions
Our retrospective data seem to indicate that heparin in digit replantation and revascularization
appears to have no benefit on digit survival across all subgroups, including crush
and avulsion injuries, and is associated with a significantly increased rate of complications.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: October 17, 2022
Accepted:
August 10,
2022
Received:
November 26,
2021
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
