ArticlePlastic and reconstructive surgery. Global open2020
Perioperative Thromboprophylaxis in Digital Replantation: A Systematic Review.
Article in Plastic and reconstructive surgery. Global open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed.
- Postoperative vascular compromise after digital replantation or revascularization: timing, risk factors, and salvage outcomes in a single-center retrospective cohort.Frontiers in medicine · 2026Article
- Retrospective Analysis of Functional Outcome of Distal Fingertip Replants Without Heparin.Journal of hand surgery global online · 2025Article
- Principles of microvascular surgery in the upper extremity.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Review
- Technical considerations for replantation: from bony fixation to soft tissue coverage.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Current trends in digital replantation-a narrative review.Annals of translational medicine · 2024Review
- Determinants of Success in Single- and Multi-Digit Replant.Plastic surgery (Oakville, Ont.) · 2023Article
- Indications, anaesthesia and postoperative protocol for replantation and revascularization in the hand in Nordic countries.The Journal of hand surgery, European volume · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
There is no international consensus on the use of perioperative thromboprophylaxis in digital replantation. Suboptimal perioperative management may lead to replant failure, which compromises extremity function, worsens psychosocial outcomes for patients, and incurs significant cost. This systematic review evaluates and compares the efficacy and safety of perioperative antithrombotic protocols used in digital replantation.
methodsA Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)--compliant prospectively registered (PROSPERO, CRD42018108695) systematic review was conducted. Cochrane Central Register of Controlled Trials, Medline, EMBASE, and Scopus were searched up until December 2019. Articles were assessed for eligibility in duplicate by 2 independent reviewers. All comparative studies that examined the use of perioperative thromboprophylaxis in digital replantation were eligible for inclusion.
resultsCollectively, 1,025 studies were identified of which 7 met full inclusion criteria reporting data from 635 patients (908 digital replants, 86% men, average age 37.3 years). Laceration was the most commonly reported mechanism of injury (68%), with 33% of replantation occurring in Tamai zone III. Fourteen distinct perioperative protocols were identified. One study reported significantly higher digital survival with continuous heparin infusion versus bolus heparin. Five studies demonstrated a significantly higher incidence of complications among patients treated with systemic heparin.
conclusionsThe clinical efficacy and safety of perioperative antithrombotic therapy following digital replantation remains equivocal. The perceived benefits of improved digital survival must be tempered against the adverse systemic side effects of antithrombotic and anticoagulant therapies until further prospectively collected data sets become available.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.