=====Secondary procedures following digital replantation and revascularisation=====

====Abstract====
In this retrospective study, 79 digits of 55 patients received 102 secondary procedures following replantation. We divided the procedures into two groups, occurring before or after 2 months following replantation. The procedures in the early group were mainly for soft tissue coverage (92%), and those in that late group were mainly for tendon (67%) to improve function. Factors associated with higher incidence of early secondary procedures included multiple-finger injury, avulsion or degloving injury and level of injury proximal to zone III in finger replantation ðp , 0:05Þ: However, younger patients and those with proximal level replantation in fingers had more late secondary procedures ðp , 0:05Þ: Flexor tenolysis procedure significantly improved the digital function after replantation ðp , 0:05Þ: q 2003 

====Commentary====
===Definition of secondary procedures===
  * describes exploration and revision of vascular anastomosis as secondary procedures

===Classification===
  * Early < 2 months -- mainly soft tissue coverage
  * Late > 2 months -- tendon

===Numbers ===
  * 79 digits, 55 patients, 102 secondary procedures
  * 32% had secondary procedures; range from 1-4 procedures: 1:22, 2: 21, 3: 10, 4: 2

===When to do tenolysis after replantation?===
  * Yu advocates are 6 months
  * quotes Jupiter 4-6 months

===Results of tenolysis after replantation===
  * Tamai score improve 67-84
  * no worse
  * no digit loss

====Source=====
Yu, J.-C., Shieh, S.-J., Lee, J.-W., Hsu, H.-Y., & Chiu, H.-Y. (2003). Secondary procedures following digital replantation and revascularisation. British Journal of Plastic Surgery, 56(2), 125–128. https://doi.org/10.1016/S0007-1226(03)00033-X

====See also====
  * [[md:secondary_surgery_trauma|Secondary Surgery]]

===History====
  * 2020-07-13 created as .txt
  * 2020-08-08 transcribed to dokuwiki and minor additions