Zengtao Wang1, Lei Zhu1, Wei Kou1, Wenhai Sun1, Bo He1, Chunxia Wang1, Yun Shen1, Yang Wang1, Zhaowei Zhu1, You Liang1. 1. From the Department of Hand and Foot Surgery, Provincial Hospital Affiliated with Shandong University; Department of Hand and Foot Surgery, Qilu Hospital of Shandong University; Department of Plastic Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University; Department of Orthopedics, The Third Affiliated Hospital of Sun Yat-sen University; Departments of Orthopedics and Plastic Surgery, The First Affiliated Hospital of Sun Yat-sen University; Core Lab, Provincial Hospital Affiliated with Shandong University; National Health and Family Planning Commission of the People's Republic of China; Department of Hand Surgery, Second Affiliated Hospital of Shandong University; and Department of Hand and Foot Surgery, Jinan Traditional Chinese Medicine Hospital Affiliated to Shandong University of Traditional Chinese Medicine.
Abstract
BACKGROUND: Although cryopreservation has been widely used in clinical practice, it remains limited to small or thin bloodless tissues with a simple structure and function. In August of 2002, the authors performed the first successful transplantation of a cryopreserved vascularized rat hind limb. Subsequently, the authors extended this cryopreservation technique to the preservation of human fingers. METHODS: In December of 2002 and December of 2003, the authors performed two in situ implantations of cryopreserved amputated fingers for two patients by means of the "two-step" and programmed cryopreservation methods. In case 1, computed tomographic angiography was performed on the affected hand 6 months after surgery. In case 2, pieces of skin were obtained from the thawed amputated finger for pathologic examination before replantation. RESULTS: One finger was cryopreserved for 81 days and the other for 5 days. Both fingers were replanted successfully. Computed tomographic angiography revealed a patent radial proper digital artery in case 1. The pathologic results of case 2 showed satisfactory skin cell morphology. After 15- and 14-year follow-up assessments of the two patients, the replanted fingers achieved satisfactory appearance and function. CONCLUSIONS: The authors confirmed the effectiveness of deep cryopreservation for the long-term preservation of human fingers. The current application scope of these cryopreservation techniques includes small limbs with minimal amounts of muscle tissue. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
BACKGROUND: Although cryopreservation has been widely used in clinical practice, it remains limited to small or thin bloodless tissues with a simple structure and function. In August of 2002, the authors performed the first successful transplantation of a cryopreserved vascularized rat hind limb. Subsequently, the authors extended this cryopreservation technique to the preservation of human fingers. METHODS: In December of 2002 and December of 2003, the authors performed two in situ implantations of cryopreserved amputated fingers for two patients by means of the "two-step" and programmed cryopreservation methods. In case 1, computed tomographic angiography was performed on the affected hand 6 months after surgery. In case 2, pieces of skin were obtained from the thawed amputated finger for pathologic examination before replantation. RESULTS: One finger was cryopreserved for 81 days and the other for 5 days. Both fingers were replanted successfully. Computed tomographic angiography revealed a patent radial proper digital artery in case 1. The pathologic results of case 2 showed satisfactory skin cell morphology. After 15- and 14-year follow-up assessments of the two patients, the replanted fingers achieved satisfactory appearance and function. CONCLUSIONS: The authors confirmed the effectiveness of deep cryopreservation for the long-term preservation of human fingers. The current application scope of these cryopreservation techniques includes small limbs with minimal amounts of muscle tissue. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
Authors: Soumen Das De; Zhen Chang Liang; Andre Eu-Jin Cheah; Mark Edward Puhaindran; Ellen Yutan Lee; Aymeric Yu Tang Lim; Alphonsus Khin Sze Chong Journal: J Hand Surg Am Date: 2020-07-29 Impact factor: 2.230