Temporary ectopic implantation for salvaging amputated parts: A systematic review.

BACKGROUND: Temporary ectopic implantation is an option when handling severe crushing injuries to the distal extremities or other body parts. The surgical techniques applied in those cases, and the patient outcomes have not been previously analyzed.

METHODS: Extensive literature search was performed using PubMed, EMBASE, and Google Scholar to collect articles reporting outcomes of temporary ectopic implantation for salvaging amputated extremities or other body parts. Age and sex of patients, injured part, amputation level, surgical details, and clinical outcomes were recorded.

RESULTS: Twenty-two articles encompassing 38 amputated cases met the inclusion criteria. The publication dates ranged from 1986 to 2016. Of the 38 cases, temporary ectopic implantation procedures were performed in 16 digit cases, 10 hand cases, 3 forearm cases, 5 foot cases, 1 penis case, 1 testes case, and 2 scalp cases. The ectopic implantation duration varied from 6 to 319 days. The ectopic implantation and following replantation of the amputated parts resulted in a survival rate of 81.6% and 100%, respectively. With different follow-up durations, most patients were found to have sensation restore in the tips of reconstructed extremities, and those reconstructed extremities were functionally useful in daily lives. The function of other replanted parts was also satisfactory.

CONCLUSION: Temporary ectopic implantation is a valuable technique for salvaging amputation cases resulted from severe crushing injuries. There is yet no consensus on the indications of this surgical technique. In future practices, both success and failure cases should be recorded and analyzed to help us to optimize the surgical strategies and improve the patient outcomes.

LEVEL OF EVIDENCE: Systematic review, level IV.