Analysis Of The Factors Influencing Survival Of Patients With Replantation Of Severed Finger

Replantation of the amputated fingers is a common surgery in hand surgery. Asthe development of microsurgery technic, the survival rate of amputated fingers hasbeen increasing year by year. More and more patients get their amputated fingersreplanted with normal appearance and partial function. But there still are some factorswhich can influence the survival of the fingers. It is a hot topic to explore thesefactors for the medical workers. Adverse psychological factor is such a factor whichshould not be ignored. In this study, we will analyze the possible factors which mayaffect the survival rate, and provide information for formulating regime for highersurvival rate.ObjectiveSurveying general characteristics, injury feature, treatment situation andpsychological status, analyzing the affected factors for patients with replanted fingers,expecting to put forward the effective ways to improve the survival rate ofreplantation, solving the psychological problems via mental health education andguidance, improving the clinical survival rate of replantation, providing scientificbasis for medical staff to make measures to improve the clinical survival rate ofreplantation.MethodsEvaluating the anxiety and depression status by Zung Self—rating DepressionScale(SDS), and State Trait Anxiety Inventory(STAI). The population is the inpatientswith replantation of amputated fingers in the hand surgery department of China-Japanunion hospital of Jilin university from2012to2013. There are105respondentscombining their medical record information. Epidata3.0for data input, SPSS13.0fordata analysis. sfor measurement data, M（QL,QU）for central tendency. Rate orconstituent ratio for counting data. T or χ2test for single factor analysis. non-conditionlogistic regression model for multi-factors analysis.Results1. Most patients with amputated finger injure1finger, ground injury is the mostcommon, complete amputation accounts for65.7%. Most amputated fingers weresaved in room temperature, the ratio is56.2%. The average time from injury to admission is5hours (3-7hours), the fastest is1hour, the slowest is60hours.70patients come for a doctor in6hours, accounting for66.7%. There are more patientsin April and May.2. Local anesthesia is often used in finger replantation surgery, the kirschner wireis the main fixation material. For every finger, the anastomosis of1artery or2arteriesis often used. There is no vein for anastomosis in about20.0%patients. Tendons andnerves are often repaired in the primary surgery. The survival rate is61.9%. The timeof hot lamp use is8.36±2.81days. The average period of therapy is10.44±3.94days.3. The average score of SDS is52.70±9.62,49.17±11.49for AS-AI,49.18±11.08for T-AI. The proportion of mild and severe depression in this subjects are29.5%and25.7%.4. Single factor analysis reveals the factors which affect the survival ofamputated fingers: injury property, injury type, time from injury to admission, colorof finger, skin temperature, and stomach elasticity.5. Multiple factor analysis reveals that the low skin temperature is a dangeroussignal, high SDS score and high TAI are dangerous factors.Conclusion1.There are more males than female in patients with amputated fingers, mainlyworkers or farmers with low education level. The injury is likely to happen in Apriland May.2.Depression is common in patients with amputated fingers replantation.3.Low skin temperature and higher SDS and TAI scores are dangerous factors foramputated fingers survive.