Mejora de la calidad de vida y funcionalidad en pacientes con reimplante de miembro superior. Un estudio prospectivo sobre tipología de los pacientes

Andrea Bueno

doi:10.31637/epsir-2024-755

Authors

Andrea Bueno Centro de Salud las Huelgas https://orcid.org/0009-0000-0292-6841

DOI:

https://doi.org/10.31637/epsir-2024-755

Keywords:

quality of life, upper limb reimplantation, functionality, occupational engagement, rehabilitation, QUICK-DASH, Russell test, patient profile

Abstract

Introduction: Quality of life and function following upper limb replantation are crucial for patient satisfaction and prognosis after the intervention. The Plastic Surgery Service at the University Hospital of Burgos conducted a study to investigate the profile of patients undergoing replantation and other variables that influence function and quality of life post-replantation. Methodology: A cross-sectional, non-experimental study was conducted with a sample of 22 patients. A questionnaire was used to collect data, including sociodemographic and medical variables, as well as subjective evaluations of functionality and quality of life. Results: There is a high rate of employment and activity recovery following replantation. The primary injuries are due to work-related accidents. It highlights the variability in the number of rehabilitation sessions and the high percentage of patients who undergo rehabilitation in private centres. Discussions: Various studies highlight the return to work and daily activities as a critical measure of post-replantation quality of life. Conclusions: The high employment rate post-reimplantation reflects an improvement in quality of life, functionality, and general satisfaction. However, significant deficiencies were identified in the public rehabilitation service provision.

Downloads

Download data is not yet available.

Author Biography

Andrea Bueno, Centro de Salud las Huelgas

Andrea Bueno holds a degree in Medicine. She is a Resident Doctor in Family and Community Medicine at the Las Huelgas Health Center in Burgos (Spain). She has a Master's in Aesthetic, Regenerative, and Anti-Aging Medicine from the Complutense University of Madrid. She is a PhD candidate at the University of Burgos. She collaborates with the University of Burgos (Spain) by teaching a health and first aid course in the Expert Course for Young People with Intellectual Disabilities. She has participated in various national and international congresses and scientific meetings and has several indexed publications. She is a member of the recognized research group DISCONDU (Disability and Behavior) at the University of Burgos.

References

Atkin, S. E., Winterton, R. I. S.y Kay, S. P. (2008). Upper limb amputations: Where, when and how to replant. Orthopaedics and Trauma, 22(1), 31-41. https://doi.org/10.1016/j.cuor.2008.02.001 DOI: https://doi.org/10.1016/j.cuor.2008.02.001

Axelrod, T. y Büchler, U. (1991). Severe complex injuries to the upper extremity: revascularization and replantation. The Journal of Hand Surgery, 16(4), 574-584. https://doi.org/10.1016/0363-5023(91)90176-C DOI: https://doi.org/10.1016/0363-5023(91)90176-C

Beaton, D. E., Katz, J. N., Fossel, A. G., Wright, J. G., Tarasuk, V. y Bombardier, C. (2001). Measuring the whole or the parts? Validity, reliability, and responsiveness of the disabilities of the arm, shoulder and hand outcome measure in different regions of the upper extremity. J. Hand Ther, 14, 128–142. https://doi.org/10.1016/S0894-1130(01)80043-0 DOI: https://doi.org/10.1016/S0894-1130(01)80043-0

Björkman, A., Rosberg, H. E. y Dahlin, L. B. (2024). Disability and health after replantation or revascularization in the upper extremity in a population in southern Sweden: A retrospective long-term follow-up. BMC Musculoskeletal Disorders, 25(1), 456. https://doi.org/10.1186/s12891-024-06678-2

Bott, S., Rachunek, K., Medved, F., Bott, T., Daigeler, A. y Wahler, T. (2022). Resultado funcional después del reimplante de dedos versus amputación. Journal of Orthopaedic Trauma, 23(1), 35. https://doi.org/10.1186/s10195-022-00654-7 DOI: https://doi.org/10.1186/s10195-022-00654-7

Bound Alberti, F., Ridley, M., Herrington, E., Benedict, J. L. y Hall, S. (2022). What we still don't know about vascularized composite allotransplantation (VCA) outcomes and quality of life measurements. Transplant. Rev. 36:100708. https://doi.org/10.1016/j.trre.2022.100708 DOI: https://doi.org/10.1016/j.trre.2022.100708

Bueno, A., Nevado-Sáchez, E., De la Fuente-Anuncibay, R. y González-Bernal, J. (2024). Functional outcomes in upper limb replantation: A systematic review. Journal of Clinical Medicine, 13(5), 1289. https://doi.org/10.3390/jcm13051289 DOI: https://doi.org/10.3390/jcm13051289

Ciclamini, D., Tos, P., Magistroni, E., Panero, B., Titolo, P. y Da Rold, I. (2013). Resultados funcionales y subjetivos de 20 reimplantes de pulgar. Injury, 44(4), 504-507. https://doi.org/10.1016/j.injury.2012.11.009 DOI: https://doi.org/10.1016/j.injury.2012.11.009

Desmond, D. M. (2007). Coping, affective distress, and psychosocial adjustment among people with traumatic upper limb amputations. J. Psychosom. Res., 62, 15–21. https://doi.org/10.1016/j.jpsychores.2006.07.027 DOI: https://doi.org/10.1016/j.jpsychores.2006.07.027

Desteli, E. E., Imren, Y., Erdogan, M., Sarisoy, G. y Cosgun, S. (2014). Comparison of upper limb amputees and lower limb amputees: a psychosocial perspective. Eur. J. Trauma Emerg. Surg., 40, 735–739. https://doi.org/10.1007/s00068-014-0418-3 DOI: https://doi.org/10.1007/s00068-014-0418-3

Ferrer Lozano, Y., Rodríguez, I. y Pérez Ferro, L. (2009). Superior limb reimplantation. Case presentation. Revista Electrónica de las Ciencias Médicas en Cienfuegos. Medisur, 7(3), 65-69.

Ferry, N., Devilliers, H., Pauchot, J., Obert, L. y Tropet, Y. (2012). Macro-replantation of the upper limb: Long-term results and quality of life. Chirurgie de la Main, 31(5), 227-233. https://doi.org/10.1016/j.main.2012.08.004 DOI: https://doi.org/10.1016/j.main.2012.08.004

Giardi, D., Crosio, A., Da Rold, I., Magistroni, E., Tos, P. y Titolo, P. (2020). Resultados clínicos a largo plazo de 33 reimplantes de pulgar. Injury, 51(4), 571-576. https://doi.org/10.1016/j.injury.2020.11.006 DOI: https://doi.org/10.1016/j.injury.2020.11.006

Godoy, J. y Mendes, R. (2004). Compartment syndrome of the upper limb: Case reports. Sci. med, 14(4), 301-303. http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1727-897X2009000300010&lng=es&tlng=es

Gulgonen, A. y Ozer, K. (2012). Long-term results of major upper extremity replantations. Journal of Hand Surgery (European Volume), 37(3), 225-232. https://doi.org/10.1177/1753193411427228 DOI: https://doi.org/10.1177/1753193411427228

Gürbüz, K. y Yontar, Y. (2021). Una experiencia de cuatro años en un hospital comunitario con respecto a procedimientos para la reimplantación y revascularización de los dedos. Joint Diseases and Related Surgery, 32(2), 383-390. https://doi.org/10.52312/jdrs.2021.32 DOI: https://doi.org/10.52312/jdrs.2021.32

Khan, N., Rashid, M., Rashid, H., Rehman Sarwar, S., Khalid Choudry, U. y Khurshid, M. (2019). Resultados funcionales de los procedimientos secundarios en el reimplante y revascularización de las extremidades superiores. Cureus, 11(7). https://doi.org/10.7759/cureus.5164 DOI: https://doi.org/10.7759/cureus.5164

Kumnig, M., Jowsey, S. G., Moreno, E., Brandacher, G., Azari, K. y Rumpold, G. (2014). An overview of psychosocial assessment procedures in reconstructive hand transplantation. Transpl. Int., 27, 417–427. https://doi.org/10.1111/tri.12220 DOI: https://doi.org/10.1111/tri.12220

Laing, T., Cassell, O., O'Donovan, D. y Eadie, P. (2012). Resultados funcionales a largo plazo de reimplantes importantes de extremidades. Journal of Plastic, Reconstructive y Aesthetic Surgery, 65(7), 931-934. https://doi.org/10.1016/j.bjps.2012.01.012 DOI: https://doi.org/10.1016/j.bjps.2012.01.012

Mattiassich, G., Rittenschober, F., Dorninger, L., Rois, J., Mittermayr, R. y Ortmaier, R. (2017). Resultado a largo plazo tras el reimplante de una extremidad superior después de una amputación traumática mayor. BMC Musculoskeletal Disorders, 18(1), 77. https://doi.org/10.1186/s12891-017-1442-3 DOI: https://doi.org/10.1186/s12891-017-1442-3

Medling, B. D., Bueno, R. A., Russell, R. C. y Neumeister, M. W. (2007). Replantation outcomes. Clinics in Plastic Surgery, 34(2), 177-185. https://doi.org/10.1016/j.cps.2006.11.001 DOI: https://doi.org/10.1016/j.cps.2006.11.003

Molski, M. (2007). Replantation of fingers and hands after avulsion and crush injuries. Journal of Plastic, Reconstructive y Aesthetic Surgery, 60(7), 748-754. https://doi.org/10.1016/j.bjps.2007.03.009 DOI: https://doi.org/10.1016/j.bjps.2007.03.009

Ng WK., Kaur, NM. y Thoma A. (2014). Long-term outcomes of major upper extremity replantations. Plastic Surgery, 22(1), 9-13. https://doi.org/10.1177/229255031402200108 DOI: https://doi.org/10.1177/229255031402200108

Oishi, S., Agranovich, O., Zlotolow, D., Wall, L., Stutz, C. y Pajardi, G. (2019). Treatment and outcomes of arthrogryposis in the upper extremity. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 181(3), 363-371. https://doi.org/10.1002/ajmg.c.31722 DOI: https://doi.org/10.1002/ajmg.c.31722

Okumuş, A. y Ozkan, A. (2020). Upper extremity replantation results in our series and review of replantation indications. Ulusal travma ve acil cerrahi dergisi. Turkish Journal of Trauma y Emergency Surgery: TJTES, 26(1), 123-129. https://doi.org/10.14744/tjtes.2019.85787 DOI: https://doi.org/10.14744/tjtes.2019.85787

Paterson, M. C. y Burke, F. D. (1995). Psychosocial consequences of upper limb injury. J. Hand Surg. (Br.), 20, 776–781. https://doi.org/10.1016/S0266-7681(95)80046-8 DOI: https://doi.org/10.1016/S0266-7681(95)80046-8

Petruzzo, P., Lanzetta, M., Dubernard, J. M., Landin, L., Cavadas, P. y Margreiter, R. (2010). The international registry on hand and composite tissue transplantation. Transplantation, 90, 1590–1594. https://doi.org/10.1097/TP.0b013e3181ff1472 DOI: https://doi.org/10.1097/TP.0b013e3181ff1472

Rosberg, H. E. (2014). Discapacidad y salud después de la reimplantación o revascularización en la extremidad superior en una población del sur de Suecia: Un seguimiento retrospectivo a largo plazo. BMC Musculoskeletal Disorders, 15(1), 73. https://doi.org/10.1186/1471-2474-15-73 DOI: https://doi.org/10.1186/1471-2474-15-73

Russell, R., O'Brien, B., Morrison, W., Pamamull, G. y Macleod, A. (1984). The late functional results of upper limb revascularization and replantation. The Journal of Hand Surgery, 9(5), 623-633. https://doi.org/10.1016/S0363-5023(84)80001-5 DOI: https://doi.org/10.1016/S0363-5023(84)80001-5

Salminger, S., Sturma, A., Roche, A. D., Hruby, L. A., Paternostro-Sluga, T. y Kumnig, M. (2016). Functional and psychosocial outcomes of hand transplantation compared with prosthetic fitting in below-elbow amputees: a multicenter cohort study. PLoS OneK, 11. https://doi.org/10.1371/journal.pone.0162507 DOI: https://doi.org/10.1371/journal.pone.0162507

Saradjian, A., Thompson, A. R. y Datta, D. (2008). The experience of men using an upper limb prosthesis following amputation: positive coping and minimizing feeling different. Disabil. Rehabil. 30, 871–883. https://doi.org/10.1080/09638280701427386 DOI: https://doi.org/10.1080/09638280701427386

Shores, J. T., Malek, V., Lee, W. P. A. y Brandacher, G. (2017). Outcomes after hand and upper extremity transplantation. J Mater. Sci. Mater., 28. https://doi.org/10.1007/s10856-017-5880-0 DOI: https://doi.org/10.1007/s10856-017-5880-0

Singh, M., Oser, M., Zinser, J., Sisk, G., Carty, M. J. y Sampson, C. (2015). Psychosocial outcomes after bilateral hand transplantation. Plast. Reconstr. Surg. Glob. Open, 3(e533). https://doi.org/10.1097/GOX.0000000000000520 DOI: https://doi.org/10.1097/GOX.0000000000000520

Sugun, T., Ozaksar, K., Ada, S., Kul, F., Ozerkan, F., Kaplan, I., Ademohlu, Y., Kayalar, M., Bal, E., Toros, T. y Bora, A. (2009). Long-term results of major upper extremity replantations. Acta Orthopaedica et Traumatologica Turcica, 43(3), 206-213. https://doi.org/10.3944/AOTT.2009.206 DOI: https://doi.org/10.3944/AOTT.2009.206

Tintle, S. M., LeBrun, C., Ficke, J. R. y Potter, B. K. (2016). What is new in trauma-related amputations. J. Orthop. Trauma, 30, S16–S20. https://doi.org/10.1097/BOT.0000000000000668 DOI: https://doi.org/10.1097/BOT.0000000000000668

Tyner, C., Slotkin, J., Kisala, P., Levin, L., Tintle, S. y Tulsky, D. (2023). Assessment of quality of life after upper extremity transplantation: Framework for patient-reported outcome scale domains. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.989593 DOI: https://doi.org/10.3389/fpsyg.2022.989593

Virués-Ortega, J., Martínez-Martín, P., Del Barrio, J. y Lozano, L. (2007). Validación transcultural de la Escala de Sentido de Coherencia de Antonovsky (OLQ-13) en ancianos mayores de 70 años. Medicina Clínica, 128(13), 486-492. https://doi.org/10.1157/13100935 DOI: https://doi.org/10.1157/13100935

Ware, J. E., Kosinski, M., Turner-Bowker, D. M. y Gandek, B. (2002). How to score version 2 of the SF-12 Health Survey (with a supplement documenting version 1). QualityMetric, Inc.

Ware, J. E., Kosinski, M. y Keller, S. D. (1996). A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220-233. https://doi.org/10.1097/00005650-199603000-00003 DOI: https://doi.org/10.1097/00005650-199603000-00003

Ware, J. E., Snow, K. K., Kosinski, M. y Gandek, B. (1993). SF-36 Health Survey: Manual and interpretation guide. The Health Institute, New England Medical Center.