Abstract

RUIZ-ALONSO, Elena et al. Epidemiological, surgical and therapeutic differences in upper limb replantation in pediatric patients. Cir. plást. iberolatinoam. [online]. 2017, vol.43, suppl.1, pp.s107-s115. ISSN 1989-2055.

Background and Objective. Replantation and revascularization of upper limb in pediatric patients are uncommon processes. Also have epidemiological, surgical and therapeutic differential characteristics that should be known by all those specialists engaged in the treatment of this pathology for trying to get an outcome as satisfactory as possible. We present a retrospective study of cases of replantation and revascularization in patients treated by Plastic Surgery Unit in Burgos hospital (Burgos, España). Methods. We review data from all patients with age less or equal to 18 years old during the years 2001-2010. For the evaluation of vascular success and its different variables, an analytical study was added by applying Fisher's exact test. We also describe in detail the differences with adult patients, both the surgical technique and postoperative care and treatment; emphasizing those conditions which we believe improve both the quality of patient care and surgical success. Results. Forty-eight processes from forty different patients were included. The incidence rate of aggregated data from these injuries during the study period, found in our stable reference area is 0.42 / 100.000 childyears. Conclusions. Because of the high frequence of contundent traumatisms and the special characteristics of patients, replantation and revascularization of upper limb in pediatric patients usually get worse results. Nevertheles, thanks to their high cerebral plasticity and their high adaptabilitiy, functional and sensitive recover use to be complet in all cases; for this reason, indication of replantation and revascularization is mandatory in all the cases, and it must be conducted by experimented and qualified experts. The only pronostic factor for surgical success with statistical signification in our group of patients was injure mechanism.

Keywords : Amputation; Replantation; Revascularization; Upper extremity; Child.

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