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Spraying bFGF for Successful Fingertip Replantation
Kensuke Tashiro, MD1; Isao Koshima, MD1; Takeshi Todokoro, MD1; Taku Iwamoto, MD2; (1)The University of Tokyo, (2)Tomei Atsugi Hospital
The University of Tokyo, Tokyo, Japan

[introduction] Doing replantation for fingertip amputation is still difficult because this kind of injury sometimes includes damaged vessels or the diameter of vessel is too small especially in vein. This time we present new technique of helping successful fingertip replantation using bFGF which is one of growth factor and stimulates angiogenesis, granulation and epithelization. [patients and methods] We experienced 5 cases of finger replantation. The age of patients is 7 to 63(average 32). In 3 cases, we conducted only arterial anastomosis because veins are too small and operation time is limited. In 1 case, we did composite graft without anastomosis because the patient is 7 years old and blood vessel is tiny. Our new technique is spraying bFGF(Fiblast(R), Kaken Pharmaceutical co ltd, Tokyo Japan) to both cut surfaces of an ampupated finger just before closing wound. [result] The result is excellent and all fingers were living without necrosis. In post operative period, no ischemic signs and no congestion signs were appeared. In 1 case, we re-opened wound to check patency of anastomosis vessels and to do delayed venous drainage and we could find vascular angiogenesis just 10 hours after spraying bFGF. [conclusion] bFGF has strong effect of vascular angiogenesis. Spraying bFGF to both cut surfaces of amputated finger is useful if vascular anastomosis is difficult such as finger tip amputation or damaged vessel.


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