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The Journal of Hand Surgery Oct 2021A persistent challenge that has limited access and delivery of digit replantation surgery is timing, as ischemia time has traditionally been considered an important... (Review)
Review
A persistent challenge that has limited access and delivery of digit replantation surgery is timing, as ischemia time has traditionally been considered an important determinant of success. However, reports that the viability of amputated digits decreases after 6 hours of warm ischemia and 12 hours of cold ischemia are largely anecdotal. This review evaluates the quality and generalizability of available evidence regarding ischemia times after digit amputation and reported outcomes of "delayed" replantation. We identify substantial limitations in the literature supporting ischemia time cutoffs and recent evidence supporting the feasibility of delayed digit replantation. The current treatment approach for amputation injuries often necessitates transfers or overnight emergency procedures that increase costs and limit availability of digit replantation nationwide. Evidence-based changes to digit replantation protocols could lead to broader availability of this service, as well as improved care quality.
Topics: Amputation, Surgical; Amputation, Traumatic; Finger Injuries; Fingers; Humans; Replantation
PubMed: 34376294
DOI: 10.1016/j.jhsa.2021.07.007 -
The Veterinary Clinics of North... Nov 2016Diseases of the bovine digit remain the major cause of painful lameness in cattle and commonly constitute a diagnostic and therapeutic challenge for clinicians. Prompt... (Review)
Review
Diseases of the bovine digit remain the major cause of painful lameness in cattle and commonly constitute a diagnostic and therapeutic challenge for clinicians. Prompt surgical wound revision is critical in acute injuries. Deep infections may be treated with debridement, resection of tendons, synovioscopy, joint lavage, arthrotomy and facilitated joint ankylosis. Postoperative care is more involved, lameness persists longer, and cost of treatment is higher after salvage techniques than after amputation of the digit. Luxations and fractures of the digits often are amenable to conservative treatment but may be treated surgically if indicated.
Topics: Amputation, Surgical; Animals; Cattle; Cattle Diseases; Female; Foot Ulcer; Fractures, Bone; Hindlimb; Lameness, Animal
PubMed: 27719768
DOI: 10.1016/j.cvfa.2016.05.011 -
Frontiers in Cell and Developmental... 2023Understanding the remarkable capacity of vertebrates to naturally regenerate injured body parts has great importance for potential translation into human therapeutic... (Review)
Review
Understanding the remarkable capacity of vertebrates to naturally regenerate injured body parts has great importance for potential translation into human therapeutic applications. As compared to other vertebrates, mammals have low regenerative capacity for composite tissues like the limb. However, some primates and rodents can regenerate the distal tips of their digits following amputation, indicating that at least very distal mammalian limb tissues are competent for innate regeneration. It follows that successful digit tip regenerative outcome is highly dependent on the location of the amputation; those proximal to the position of the nail organ do not regenerate and result in fibrosis. This distal regeneration proximal fibrosis duality of the mouse digit tip serves as a powerful model to investigate the driving factors in determining each process. In this review, we present the current understanding of distal digit tip regeneration in the context of cellular heterogeneity and the potential for different cell types to function as progenitor cells, in pro-regenerative signaling, or in moderating fibrosis. We then go on to discuss these themes in the context of what is known about proximal digit fibrosis, towards generating hypotheses for these distinct healing processes in the distal and proximal mouse digit.
PubMed: 37325560
DOI: 10.3389/fcell.2023.1217185 -
International Journal of Audiology Dec 2021This review article presents an overview of all Digit Triplet Tests (DTT) and digits-in-noise tests (DIN) and their variations in language, speech material, masking... (Review)
Review
OBJECTIVE
This review article presents an overview of all Digit Triplet Tests (DTT) and digits-in-noise tests (DIN) and their variations in language, speech material, masking noise, test procedures, and targeted population. The effects on aspects of validity, reliability, and feasibility are investigated.
DESIGN
Scoping review.
STUDY SAMPLE
All studies referring to the DTT and DIN were collected from Pubmed and Embase. Search terms "digit triplet test" and "digits in noise" were used. Citations of selected articles were scanned backwards in time (the bibliography of the already selected research article) and forward in time (articles that cited the already selected research article). The search terms yielded 95 results in total. Eventually, 39 papers were selected.
RESULTS
Analyses showed psychometric reference-curves with steep slopes and speech reception thresholds with high measurement precision which are strongly associated with pure tone audiometry. High sensitivity and specificity to detect elevated pure tone thresholds were noted for test variants. Certain procedural modifications of the DTT and DIN can further improve the test. Additionally, large-scale application of the DTT and DIN is feasible.
CONCLUSION
The DTT and DIN are a very valuable tool for screening and diagnostics for a wide variety of populations.
Topics: Audiometry, Pure-Tone; Humans; Noise; Reproducibility of Results; Speech Perception; Speech Reception Threshold Test
PubMed: 33840339
DOI: 10.1080/14992027.2021.1902579 -
British Journal of Hospital Medicine... Nov 2020Traumatic digit amputations account for 1% of all trauma admissions and are an important cause of morbidity in young, working people. It is essential that patients are... (Review)
Review
Traumatic digit amputations account for 1% of all trauma admissions and are an important cause of morbidity in young, working people. It is essential that patients are worked up appropriately and referred promptly to a specialist unit for consideration of replantation. This review summarises the acute management of a patient presenting to the emergency department with an amputated digit. It discusses the assessment, initial management in the emergency department, how to make the decision to replant and operative steps.
Topics: Amputation, Traumatic; Emergency Service, Hospital; Finger Injuries; Humans; Replantation
PubMed: 33263473
DOI: 10.12968/hmed.2020.0087