Analysis of risk factors for post-replantation necrosis in complete multi-finger amputation.

Objective: This study aims to summarize the risk factors affecting the survival rate of multiple fingers after replantation. Method: A retrospective analysis was conducted on cases of completely amputated multiple fingers that underwent multi-finger replantation. Patients were divided into survival, partial survival, and necrosis groups based on the replantation outcome. The replanted fingers were categorized into survival and necrosis groups (fingers). The impact of factors on the survival rates of replantation was analyzed. Results: A total of 201 patients with 650 fingers were included in the study. Univariate analysis showed that the surgery duration was significantly longer in the partial survival group (381.4 min) and the necrosis group (401.9 min) compared to the survival group (321.5 min). The survival rate of replantation in the Tamai zone 3 (84.2 %) was higher than in zone 4 (77.1 %). Multivariate logistic analysis revealed that surgery duration and the amputation plane significantly affected the survival rates of replantation. The rate of vein graft in daytime surgery (29.8 %) was significantly higher than in nighttime surgery (25.8 %). Conclusion: In patients with complete multi-finger amputation, surgery duration and the amputation plane are risk factors affecting the survival rate of multi-finger replantation. Under well-rested conditions, surgeons tend to choose more aggressive finger preservation strategies.