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Effect of Normobaric Oxygen Therapy On Survival Of Composite Grafts in Fingertip Amputation
Jaeyoung CHO, MD; Youngwoong Choi, PhD;
Sanggye Paik Medical Center, Seoul, Korea
Introduction: Despite a low success rate, composite graft is a tolerable treatment for fingertip amputation. Various methods are utilized for improving success rate, including hyperbaric oxygen therapy. Normobaric oxygen therapy (NBO) is not yet acceptable adjuvant treatment. We analyzed if NBO can be effective in composite graft in fingertip amputation.
Method: Retrospective review was performed on fingertip amputations treated by composite graft, from January 1st, 2009 to July 1st, 2015. Patients were divided by whether received NBO or not. Graft survival was evaluated 2 weeks after operation. Follow up was done until 6 months after operation. 5 risk factors of graft failure were analyzed: age, smoking, time to surgery, diabetes mellitus, and injury type. Relationship with NBO and graft survival, amputation levels and risk factors were evaluated by Linear by linear association analysis and Logistic regression analysis.
Result: In 161 patients, there were 109 NBO treated patients and 52 non NBO treated patients. Composite graft survival increased in NBO treated group (70.6%) than in non NBO treated group (51.9%) (p=0.00). NBO increased graft survival in nail base distal area (p=0.00). Among 5 risk factors, time to surgery > 5 hours (Odds ratio: 48.6) and crush-avulsion injury type (Odds ratio: 10.1) increased graft failure. NBO decreased graft failure risk in smoking patients.
Conclusion: NBO improved survival rate of composite graft, particularly in nail base distal area. It reduced graft failure rate in smoking patients. NBO could be an acceptable adjuvant treatment option for composite graft.
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