Timing of critical thrombosis after replantation surgery of the digits.

The time at which critical thrombosis occurred was assessed in a group of 63 patients (76 digits) following replantation surgery. The influence of smoking and mechanism of injury were examined with respect to the risk of thrombosis. The highest risk of critical thrombosis after replantation occurred in the first 3 days after surgery, although some risk remained up to 2 weeks. The higher risk of late failure in smokers may represent the effects of a return to smoking after discharge. Mechanism of injury did not appear to affect the timing of critical thrombosis. This report should help surgeons plan the timing of discharge against the known ongoing risk of replantation failure. Strong advice against resumption of smoking seems to be appropriate.