Association Between Daytime vs Overnight Digit Replantation and Surgical Outcomes

Lin, I-Chun; Yoon, Alfred P.; Kong, Lingxuan; Wang, Lu; Chung, Kevin C.

doi:10.1001/jamanetworkopen.2022.29526

Cited by 2 publications

(2 citation statements)

References 61 publications

(80 reference statements)

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“…In contrast, others report a difference favoring daytime surgeries. 54,[78][79][80] Of note, many studies that found no differences in outcomes between day and night surgeries included data from large academic medical centers, which would be the least burdened by the need for an extended operation in the middle of the night.…”

Section: Discussionmentioning

confidence: 99%

“…However, this concept has been widely debated in the literature, with some articles citing no difference in complication rates between daytime and evening surgeries. In contrast, others report a difference favoring daytime surgeries 54,78–80 . Of note, many studies that found no differences in outcomes between day and night surgeries included data from large academic medical centers, which would be the least burdened by the need for an extended operation in the middle of the night.…”

Section: Discussionmentioning

confidence: 99%

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Amputated Digit Replantations

Fijany,

Chaker,

Egozi

et al. 2024

Ann Plast Surg

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Introduction A common consideration for replantation success is the ischemia time following injury and the preservation temperature. A classic principle within the hand surgery community describes 12 hours of warm ischemia and 24 hours of cold ischemia as the upper limits for digit replantation; however, these limits are largely anecdotal and based on older studies. We aimed to compare survival data from the large body of literature to aid surgeons and all those involved in the replantation process in hopes of optimizing success rates. Methods The PubMed database was queried on April 4th, 2023, for articles that included data on digit replantation survival in terms of temperature of preservation and ischemia time. All primary outcomes were analyzed with the Mantel-Haenszel method within a random effects model. Secondary outcomes were pooled and analyzed using the chi-square statistic. Statistical analysis and forest plot generation were completed with RevMan 5.4 software with odds ratios calculated within a 95% confidence interval. Results Our meta-analysis identified that digits preserved in cold ischemia for over 12 hours had significantly higher odds of replantation success than the amputated digits replanted with 0–12 hours of warm ischemia time (P ≤ 0.05). The odds of survival in the early (0–6 hours) replantation group were around 40% greater than the later (6–12 hours) replantation group (P ≤ 0.05). Secondary outcomes that were associated with higher survival rates included a clean-cut amputation, increased venous and arterial anastomosis, a repair that did not require a vein graft, and replants performed in nonsmokers (P ≤ 0.05). Discussion Overall, these findings suggest that when predicting digit replantation success, time is of the essence when the digit has yet to be preserved in a cold environment. This benefit, however, is almost completely diminished when the amputated digit is appropriately maintained in a cold environment soon after injury. In conclusion, our results suggest that there is potential for broadening the ischemia time limits for digit replant survival outlined in the literature, particularly for digits that have been stored correctly in cold ischemia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Amputated Digit Replantations

Fijany,

Chaker,

Egozi

et al. 2024

Ann Plast Surg

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Study on the application of segmented nursing pathway in daytime anorectal surgery patients

2024

THC

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BACKGROUND: Standardised management of day surgery for haemorrhoids and achieving standardised nursing in the painless ward of colorectal surgery are important. OBJECTIVE: To explore the role of segmented nursing pathways in patients undergoing day surgery for anorectal procedures and to provide theoretical and practical guidance for day surgery nursing. METHODS: A total of 146 patients undergoing anorectal surgery in our day surgery ward between April 2023 and July 2023 were selected as the study participants, with 74 patients in the control group receiving routine nursing and 72 patients in the experimental group receiving segmented nursing. The preoperative preparedness, preoperative anxiety, complication rate, discharge preparedness and nursing satisfaction were compared between the two groups. RESULTS: The experimental group had higher rates of admission before 8:30 am (77.78% vs 45.95%), awareness of the day surgery process (63.89% vs 24.32%), completion rate of preoperative preparation (81.94% vs 59.46%), satisfaction with preoperative preparation (94.44% vs 74.32%), discharge preparedness (112.42 ± 3.28 vs 95.82 ± 3.41) and nursing satisfaction (97.22% vs 70.27%) compared with the control group (P< 0.05). After the intervention, the self-rating anxiety scale score (43.14 ± 12.44 vs 52.51 ± 13.21) and the self-rating depression scale score (45.03 ± 11.37 vs 55.37 ± 10.14) were lower in the experimental group than in the control group (P< 0.05). CONCLUSION: Segmented nursing pathways can improve the preoperative preparedness of patients undergoing day surgery for anorectal procedures, alleviate patient anxiety, enhance discharge preparedness, improve the quality of nursing care and increase nursing satisfaction.

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Association Between Daytime vs Overnight Digit Replantation and Surgical Outcomes

Cited by 2 publications

References 61 publications

Amputated Digit Replantations

Amputated Digit Replantations

Study on the application of segmented nursing pathway in daytime anorectal surgery patients

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