M. Makeľ1,2, A. Sukop1, P. Waldauf3, A. Whitley4,5, A. Hora6, R. Kaiser7
1 Department of Plastic Surgery, University Hospital Královské Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic
2 Department of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic
3 Department of Anaesthesia and Intensive Care Medicine, University Hospital Královské Vinohrady, Third Faculty of Medicine, Charles University,
Prague, Czech Republic
4 Department of Surgery, University Hospital Královské Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic
5 Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic
6 Third Faculty of Medicine, Charles University, Prague, Czech Republic
7 Department of Neurosurgery and Neurooncology, First Faculty of Medicine, Charles University and Military University Hospital Prague, Czech
Republic
Summary
It is often questioned whether to perform replantation or revision amputation for amputation injuries in elderly patients and smokers. According to the current indication criteria, neither old age nor smoking in the absence of other risk factors are considered to be risk factors for replantation failure. However, many microsurgeons still may make the decision not to perform digital replantation based solely on these factors. Material and methods: In order to evaluate the influence of both factors, we provided univariate and multivariate analyses of patients who underwent replantation at our centre during a 10-year period. We divided patients in two groups according to age (< and ≥ 60 years) and smoking status. Results: In the univariate analysis, there were no differences in immediate results between the two age groups. In the multivariate analysis, no statistical difference was found in neither long-term nor short-term results between the two age groups and between smokers and non-smokers. Conclusion: Smoking and age should not be considered the only risk factors when deciding whether to perform digital replantation.
Key words
amputation injury – replantation – smoking – elderly age