Anxiety and Trauma Perception and Quality of Life in Patients Who Have Undergone Replantation

Alper Gokce; Halil Bekler; Ercan Karacaoglu; Erkan Servet; Nevzat Selim Gokay

doi:10.1055/s-0031-1284232

Journal of Reconstructive Microsurgery, Table of Contents

J Reconstr Microsurg 2011; 27(8): 475-480
DOI: 10.1055/s-0031-1284232

Anxiety and Trauma Perception and Quality of Life in Patients Who Have Undergone Replantation

Alper Gokce¹ , Halil Bekler² , Ercan Karacaoglu³ , Erkan Servet² , Nevzat Selim Gokay¹

¹Department of Orthopaedics and Traumatology, Namik Kemal University, School of Medicine, Istanbul, Turkey
²Department of Orthopaedics and Traumatology, Yeditepe University, School of Medicine, Istanbul, Turkey
³Department of Plastic and Reconstructive Surgery, Yeditepe University, School of Medicine, Istanbul, Turkey

Abstract

ABSTRACT

The difficulty in keeping an amputated limb biologically alive is overcome day by day thanks to the successful replantation procedures applied in the early period. However, the reflections of this biological success on patients in functional and psychological terms may not be pleasing all the time. In our study, we aimed to evaluate the perceptual responses of patients to trauma after replantation and their possible effects on clinical results. We conducted a retrospective study of 43 patients who underwent replantation. The average age was 32.4 years and the average follow-up period was 38.6 months. When the results of the Short Form-36 (SF-36), Beck's Depression Inventory, and the assessment scores of the disabilities of the arm, shoulder, and hand survey were evaluated, there was a negative correlation between the patients diagnosed with depression and all SF-36 subunits. A negative correlation between the severity of trauma and the average physical and mental values included in the SF-36 evaluations was observed (r = 0.48, r = 0.51, respectively),. These results revealed that the psychology of the patient was one of the important factors that could not be ignored in the success of replantation.

KEYWORDS

Replantation - anxiety and depression - quality of life

Full Text

References

REFERENCES

1 Waikakul S, Sakkarnkosol S, Vanadurongwan V, Un-nanuntana A. Results of 1018 digital replantations in 552 patients. Injury. 2000; 31 (1) 33-40
2 Nyström A, Backman C, Backman C, Bertheim U, Karlsson L, Carlsson A. Digital amputation, replantation, and cold intolerance. J Reconstr Microsurg. 1991; 7 (3) 175-178
3 Agel J, Swiontkowski M F. Guide to outcomes instruments for musculoskeletal trauma research. J Orthop Trauma. 2006; 20 (8, Suppl) S1-S146
4 Pynsent P B. Choosing an outcome measure. J Bone Joint Surg Br. 2001; 83 (6) 792-794
5 Swiontkowski M F. Why we should collect outcomes data. J Bone Joint Surg Am. 2003; 85-A (Suppl 1) S14-S15
6 Swiontkowski M F, Engelberg R, Martin D P, Agel J. Short musculoskeletal function assessment questionnaire: validity, reliability, and responsiveness. J Bone Joint Surg Am. 1999; 81 (9) 1245-1260
7 Atroshi I, Gummesson C, Andersson B, Dahlgren E, Johansson A. The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: reliability and validity of the Swedish version evaluated in 176 patients. Acta Orthop Scand. 2000; 71 (6) 613-618
8 Sullivan M, Karlsson J, Ware Jr J E. The Swedish SF-36 Health Survey—I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med. 1995; 41 (10) 1349-1358
9 Crichlow R J, Andres P L, Morrison S M, Haley S M, Vrahas M S. Depression in orthopaedic trauma patients. Prevalence and severity. J Bone Joint Surg Am. 2006; 88 (9) 1927-1933
10 Datta D, Selvarajah K, Davey N. Functional outcome of patients with proximal upper limb deficiency—acquired and congenital. Clin Rehabil. 2004; 18 (2) 172-177
11 Fisher K, Hanspal R S, Marks L. Return to work after lower limb amputation. Int J Rehabil Res. 2003; 26 (1) 51-56
12 Klauser H, Stein S, Freimark C, Flatau I, Brunnemann S, Weber U. [Rehabilitation after replantation]. Orthopade. 2003; 32 (5) 386-393
13 Waldner-Nilsson B. Amputationen im Bereich der Finger und vom Teilen der Hand. In: Waldner-Nilsson B, ed. Psychologische Bedeutung der Hand–Reaktionen auf eine Verletzung oder Erkrankung Ergotherapie in der Handrehabilitation. New York: Springer; 1997: 468-525
14 Komatsu S, Tamai S. Successful replantation of a completely cut-off thumb. Plast Reconstr Surg. 1968; 42 375-376
15 Bosse M J, MacKenzie E J, Kellam J F et al.. An analysis of outcomes of reconstruction or amputation after leg-threatening injuries. N Engl J Med. 2002; 347 (24) 1924-1931
16 Gustafsson M, Ahlström G. Emotional distress and coping in the early stage of recovery following acute traumatic hand injury: a questionnaire survey. Int J Nurs Stud. 2006; 43 (5) 557-565
17 Michaels A J, Michaels C E, Moon C H, Zimmerman M A, Peterson C, Rodriguez J L. Psychosocial factors limit outcomes after trauma. J Trauma. 1998; 44 (4) 644-648
18 Atroshi I, Gummesson C, McCabe S J, Ornstein E. The SF-6D health utility index in carpal tunnel syndrome. J Hand Surg Eur Vol. 2007; 32 (2) 198-202
19 Carlsson I K, Rosén B, Dahlin L B. Self-reported cold sensitivity in normal subjects and in patients with traumatic hand injuries or hand-arm vibration syndrome. BMC Musculoskelet Disord. 2010; 11 89
20 Williams A E, Newman J T, Ozer K, Juarros A, Morgan S J, Smith W R. Posttraumatic stress disorder and depression negatively impact general health status after hand injury. J Hand Surg Am. 2009; 34 (3) 515-522
21 Horng Y S, Lin M C, Feng C T, Huang C H, Wu H C, Wang J D. Responsiveness of the Michigan Hand Outcomes Questionnaire and the Disabilities of the Arm, Shoulder, and Hand questionnaire in patients with hand injury. J Hand Surg Am. 2010; 35 (3) 430-436
22 Beaton D E, Katz J N, Fossel A H, Wright J G, Tarasuk V, Bombardier C. 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. 2001; 14 (2) 128-146
23 Germann G, Wind G, Harth A. [The DASH(Disability of Arm-Shoulder-Hand) Questionnaire—a new instrument for evaluating upper extremity treatment outcome]. Handchir Mikrochir Plast Chir. 1999; 31 (3) 149-152
24 Macdermid J C, Fox E, Richards R S, Roth J H. Validity of pulp-to-palm distance as a measure of finger flexion. J Hand Surg [Br]. 2001; 26 (5) 432-435
25 Dabernig J, Hart A M, Schwabegger A H, Dabernig W, Harpf C. Evaluation outcome of replanted digits using the DASH score: review of 38 patients. Int J Surg. 2006; 4 (1) 30-36
26 Beals R K, Sauser D D. Nontraumatic disorders of the clavicle. J Am Acad Orthop Surg. 2006; 14 (4) 205-214
27 MacKenzie E J, Bosse M J, Pollak A N et al.. Long-term persistence of disability following severe lower-limb trauma. Results of a seven-year follow-up. J Bone Joint Surg Am. 2005; 87 (8) 1801-1809
28 Smith J J, Agel J, Swiontkowski M F, Castillo R, Mackenzie E, Kellam J F. LEAP Study Group . Functional outcome of bilateral limb threatening: lower extremity injuries at two years postinjury. J Orthop Trauma. 2005; 19 (4) 249-253
29 McCarthy M L, MacKenzie E J, Edwin D, Bosse M J, Castillo R C, Starr A. LEAP study group . Psychological distress associated with severe lower-limb injury. J Bone Joint Surg Am. 2003; 85-A (9) 1689-1697

Nevzat Selim GokayM.D.

Bulbul Cad. Badem:13, Villa:1, 34538

Bahçeşehir, Istanbul, Turkey

Email: nevzatselim@yahoo.com