PDF(Pubmed)
Abstract：
The number of amputated finger replantation has declined in the USA and Germany in recent years; however, there have been no reports on recent trends in Japan. We examined the current practices, attempts, and success factors of digit replantation in Japan. We hypothesized that the rates of digit replantation and success rates were consistently standardized in Japan. The diagnosis procedure combination database was used to analyze 14004 cases from April 2014 to March 2020, excluding multiple-digit amputations, thus focusing on 13484 patients. We evaluated replantation success rates and identified factors influencing replantation decisions using multiple logistic regression analysis. The key findings included a higher frequency of replantation in thumb cases and surgeries during overtime hours, on Sundays, and in educational institutions. Success rates were notably higher for thumb replantations and patients under 20 years of age. Patients over 65 years of age treated with urokinase showed higher failure rates, unrelated to regional or hospital case volumes. The number of amputated digit replantation surgeries in Japan was high during overtime hours, on Sundays, and in educational institutions. Region, hospital type, and hospital case volume were not associated with a low success rate across Japan.
摘要：
近年来，在美国和德国，断指再植的数量有所下降；然而，没有关于日本近期趋势的报道。我们检查了当前的做法，尝试,日本断指再植的成功因素。我们假设在日本，手指再植率和成功率一直是标准化的。诊断程序组合数据库用于分析2014年4月至2020年3月的14004例，不包括多位截肢，因此集中于13484名患者。我们使用多元逻辑回归分析评估了再植成功率并确定了影响再植决策的因素。主要发现包括拇指再植的频率更高，加班时间进行手术，周日,在教育机构。拇指再植和20岁以下患者的成功率明显更高。使用尿激酶治疗的65岁以上的患者显示出更高的失败率，与地区或医院病例量无关。日本的断指再植手术在加班时间内数量较多,周日,在教育机构。区域,医院类型,和医院病例量与整个日本的低成功率无关。
