Antithrombotic Therapies in Digit Replantation with Papaverine Administration: A Prospective, Observational Study.

BACKGROUND: The primary objective of this study was to investigate whether the application of antithrombotic therapies affects the success rate of digit replantation.

METHODS: A total 477 digits of 319 patients who received dextran with low-molecular-weight heparin, dextran with prostaglandin E1, or no antithrombotic therapy after replantation of complete amputated digits from January 1, 2012, to January 1, 2016, were included in this study. Papaverine was given by intramuscular injection to all patients at a dosage of 90 mg/day postoperatively.

RESULTS: There was no significant difference in any of the potential risk factors, including age, smoking, Tamai level of amputation, causes of injury, and warm ischemia time among groups. The survival rates of digits from patients who received dextran with low-molecular-weight heparin, dextran with prostaglandin E1, or no antithrombotic therapy were not significantly different.

CONCLUSION: Antithrombotic therapies showed no significant benefit for digit replantation in patients receiving papaverine.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.