Skip to main content

Advertisement

Volume 3 Supplement 1

ESICM LIVES 2015

Prognostic factors of poor outcome in patients with upper limb replantation surgery admitted to the icu

Article metrics

  • 224 Accesses

Intr

Our University Hospital is one of the national reference centers in upper extremity replantation surgery (ERS) (the transfer is carried out on air transportation by the National Transplant Organization, NTO). Therefore, it is important to optimize postoperative care in the ICU that may influence replantation evolution.

Objectives

To describe the characteristics of patients undergoing this surgery admitted to the ICU and to evaluate prognostic factors related with bad outcome [2].

Methods

Observational study of patients with ERS during a period of seven years (2008-2014). Computer research of electronic medical records in databases was conducted. We obtained a sample of 60 cases and classified them into two groups: good and poor outcome. We analyzed: epidemiological variables (age, smoking, diabetes, arteriopathy) variables related with injury mechanism (degloving, flattening, large bone lesion, neural lost and vascular affectation), surgery and postoperative care (amines, mechanical ventilation, transfusion, ICU stay).

We compared the factors associated with poor outcome in both groups

Results

In our sample of 60 cases 85% were male, mean age was 47,13 years, and no differences in previous comorbidities were observed. We found significant differences between the injury mechanism and the presence of large bone and vascular lesion (Table 1). Time of ischemia and surgery were comparable. There were no treatment differences in the ICU in both groups. ICU replantation survival was 93,3%, with 10% of early reoperation due to arterial thrombosis.

Table 1 Table 1

Conclusions

In our sample, large bone and vascular affectation were the factors associated with poor replantation outcome, in patients with upper extremity amputation. No differences related with surgical or postoperative care variables were observed. Replantation survival rates, and need of reoperation in our series, were consistent with literature data [3].

References

  1. 1.

    Nick Brinkman J, H. Derks Lieke, Klimek Markus, et al: Perioperative Fluid Management and Use of Vasoactive and Antithrombotic Agents in Free Flap Surgery: A Literature Review and Clinical Recommendations. J Reconstr Microsurg. 2013, 29: 357-366.

  2. 2.

    Masoomi , et al: Predictive risk factors of free flap thrombosis in breast reconstruction surgery. Microsurgery. 2014, March

  3. 3.

    Prucz RB, Friedrich JB: Upper Extremity Replantation: Current Concepts. Plast Reconstr Surg. 2014, 133: 333

Download references

Author information

Correspondence to E Portugal Rodríguez.

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Portugal Rodríguez, E., Martínez Barrio, E., Nevado Sánchez, E. et al. Prognostic factors of poor outcome in patients with upper limb replantation surgery admitted to the icu. ICMx 3, A235 (2015) doi:10.1186/2197-425X-3-S1-A235

Download citation

Keywords

  • Electronic Medical Record
  • Injury Mechanism
  • Postoperative Care
  • Arterial Thrombosis
  • Care Variable