J Korean Soc Microsurg.  2007 May;16(1):30-38.

The Fate of Neglected Vascular Injury of the Hand in Acute Hand Injuries

• Kim TB
• Lee YJ
• Lee YK
• Woo SH

Abstract

In acute hand injury, there are sometimes hattened neglected or overlooked vascular injury by primary operators. The authors evaluated the final results and prognosis after secondary revascularization. In eight cases, the authors performed secondary revascularization after prolonged warm ischemia. Five fingers in five cases among them were successfully survived and three cases finally necrosed. The mean warm ischemic time was 56.1 hours. In revascularization procedures, end-toend artery anastomosis was possible in six cases. In two cases, vein graft was needed to anastomose digital artery, which resulted in complete survival of the fingers. In all three cases, revision amputation of the fingers was done. In acute complex hand injury, the importance of evaluation of the vascular injury can not be overemphasized. The necessity of the early secondary revascularization as well as serious consequence caused by misdiagnosis of vascular injury should be aware.

Keyword

Neglected vascular injury; Acute hand injury; Delayed revascularization

MeSH Terms

Amputation
Arteries
Diagnostic Errors
Fingers
Hand Injuries*
Hand*
Prognosis
Transplants
Vascular System Injuries*
Veins
Warm Ischemia