Composite graft survival in allen zone II fingertip amputations: Independent predictors of graft failure.
Diabetes mellitus is among the strongest independent predictors of composite graft failure
Composite graft survival in allen zone II fingertip amputations: Independent predictors of graft failure.
Composite grafting is a commonly used treatment option for Allen Zone II fingertip amputations; however, reported survival rates vary considerably across studies.
This study aimed to identify independent clinical predictors of composite graft survival and to explore, secondarily, whether ischemia duration is associated with graft failure.
Forty-two patients who underwent composite grafting due to Allen Zone II fingertip amputation between December 2021 and June 2023 were retrospectively evaluated.
Graft survival was achieved in 23 cases (54.8%), while 19 cases (45.2%) resulted in failure.
Factors associated with graft failure included older age, longer ischemia duration, presence of diabetes mellitus, and crush/avulsion type injuries.
In exploratory ROC analysis an ischemia duration threshold of 4.3 h was associated with failure, although ischemia duration was not an independent predictor.
Overall, the combined evaluation of clinical variables demonstrated strong ability to distinguish between successful and unsuccessful graft outcomes.
In cases of Allen Zone II fingertip amputations, the crush/avulsion mechanism and diabetes mellitus are the strongest independent predictors of composite graft failure.
An ischemia duration exceeding 4.3 h was associated with failure in exploratory analysis but was not an independent predictor. Preoperative assessment of these parameters may inform patient selection, pending prospective validation.