OUTCOMES OF MICROSURGICAL DIGITAL REVASCULARIZATION WITH LOCAL ANESTHESIA: IS IT WORTH IT?

OBJETIVE. Report the outcomes of patients with non-viable incomplete amputations at the level of the phalanges of the hand with evidence of vascular compromise undergoing digital revascularization using local anesthesia without epinephrine – no tourniquet. METHODS The authors technique proposes microsurgical digital revascularization using local anesthesia without the use of vasoconstrictor and without tourniquet following the inclusion criteria of non-viable incomplete amputation, single vascular lesion or associated with nerve, tendon, and bone lesions. Data are obtained from 20 patients from January 2022 to June 2022 and a three-month postoperative follow-up is performed where vitality, functionality and rehabilitation results are evaluated. RESULTS Successful revascularization in 100% of the cases, the most affected area was the distal phalanx in a 75% and second and third phalanges was the most affected fingers. Despite not using vasoconstrictor and no tourniquet, adequate visibility and control of the surgical field was achieved, allowing digital revascularization in a time not exceeding 1 hour with adequate results in terms of digital vitality and functionality. CONCLUSION Digital revascularization performed under local anesthesia without epinephrine and sedation provides the hand surgeon a prudent time to perform the procedure with pain, bleeding, and digital movements control, minimizing the rate of complications and adequate functional results.