Analysis of factors affecting early necrosis of the affected finger after surgery in patients with reimplantation of severed fingers

The study aimed to investigate the factors associated with early necrosis of the finger after reimplantation of broken fingers. Sixty-seven cases of reimplantation of severed fingers in our hospital between January 2023 and December 2023 were retrospectively analyzed. All patients underwent reimplantation of severed fingers and were divided into early necrosis group and non-necrosis group according to the presence or absence of early necrosis of the finger body 7 days after surgery. The relevant data of the 2 groups were collected, and the statistically significant items were screened by univariate analysis, and then by multifactorial logistic regression analysis to determine the high-risk factors for early necrosis after reimplantation of the severed finger. Among 67 patients, 13 cases showed early postoperative necrosis, with a necrosis rate of 19.40% (13/67). The difference between the 2 groups was significant (P < .05) in the comparison of smoking history, finger type (little finger), preoperative ischemic duration, vasospasm, type of injury (crush injury), postoperative infection, and low skin temperature. Multifactorial analysis showed that smoking history (OR = 7.255, 95% CI: 1.767-29.782), little finger (OR = 7.040, 95% CI: 1.897-26.130), preoperative ischemia ≥ 8 hours (OR = 15.714, 95% CI: 3.095-79.798), vasospasm (OR = 5.850, 95% CI: 1.563-21.894), crush injury (OR = 5.667, 95% CI: 1.393-23.059), postoperative infection (OR = 5.600, 95% CI: 1.544-20.312), and postoperative hypothermia of the skin (OR = 7.096, 95% CI: 1.872-26.906) were the necrotic post-replantation necrosis after amputation of the finger high-risk factors (OR > 1, P < .05). The risk of early necrosis of the affected finger after reimplantation of an amputated finger is closely related to smoking history, pinky size, preoperative ischemic time of more than 8 hours, vasospasm, crush injuries, postoperative infections, and postoperative hypothermic skin temperature. Preventive measures need to be taken in advance to reduce the risk of necrosis in the affected finger.