Reporting Outcomes and Outcome Measures in Digital Replantation: A Systematic Review

Abstract

Purpose There is a lack of consensus on what the critical outcomes in replantation are and how best to measure them. This review aims to identify all reported outcomes and respective outcome measures used in digital replantation. Materials and Methods Randomized controlled trials, cohort studies, and single-arm observational studies of adults undergoing replantation with at least one well-described outcome or outcome measure were identified. Primary outcomes were classified into six domains, and outcome measures were classified into eight domains. The clinimetric properties were identified and reported. A total of 56 observational studies met the inclusion criteria. Results In total, 29 continuous and 29 categorical outcomes were identified, and 87 scales and instruments were identified. The most frequently used outcomes were survival of replanted digit, sensation, and time in hospital. Outcomes and measures were most variable in domains of viability, quality of life, and motor function. Only eight measures used across these domains were validated and proven reliable. Conclusion Lack of consensus creates an obstacle to reporting, understanding, and comparing the effectiveness of various replantation strategies.

Preoperative Cryopreservation Promotes Digital Survival after Digit Replantation

“…Although the reasons of failed digital replantation can be many, the pinpointing of contributory factors may help to take full advantage of successful digital replantation. Factors shown to considerably affect the rate of successful digital replantation consist of injury mechanism (avulsion or crushed digit), severity of injury, history of smoking, and history of diabetes mellitus [1][2][3][4].…”

Impact of Rectus Diastasis Repair on Abdominal Strength and Function: A Systematic Review

“…However, the studies included in this review report a limited amount of SF-36 data, and therefore we were limited in the data available for pooled analysis [6,10,21,23]. To address this heterogeneity in outcome reporting, outcome standardization, which is being undertaken in several areas of plastic surgery, would be beneficial [32][33][34][35].…”

A qualitative study of the long-term consequences and adaptation in daily life after replantation surgery at a young age

“…24,27 When presenting outcomes after replantation surgery, objective measurements of hand function are usually given along with reports of patient satisfaction and health-related quality of life. 8,22 Our participants experienced impairments in range of motion, fine motor skills, strength and sensibility. However, broad access to adaptive strategies and personal resources over the years enabled the participants to overcome challenges in daily activities.…”

“…Patients may also experience psychosocial problems as well as a negative impact on healthrelated quality of life (HRQL). [4][5][6][7][8][9][10] Appearance-related concerns are rarely evaluated after amputation and digital replantation despite the importance of an individual's self-image and well-being. 11 The degree of visible difference is related to the manifestation of posttraumatic stress disorder, symptoms of avoidance and emotional numbing.…”

“…[12][13][14] Appearance-related concerns and access to coping strategies may also influence social participation, as described in individuals with an amputation injury to the hand or congenital thumb anomalies. 15,16 Earlier reports have mainly focused on the functional outcome and survival rates after replantation surgery, but numerous confounding variables and inconsistency in reported traditional functional outcome measures 5,6,8,17,18 make it difficult to compare results from reported studies. 19 Impaired functioning and patient satisfaction, which is evaluated in the commonly used Ipsen and Tamai scores, is associated with worse DASH (Disabilities of the Arm, Shoulder and Hand) scores.…”