{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T06:45:13Z","timestamp":1774507513133,"version":"3.50.1"},"reference-count":54,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Replantation and revascularization are among the most technically challenging surgical procedures and have varying success rates. Methods to assess surgeon skill for this complex undertaking are lacking.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine whether a surgeon proficiency score is associated with clinical outcomes across multiple institutions.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This multicenter retrospective cohort study analyzed all digit replantation and revascularization after traumatic amputations for adult patients from January 1, 2000, to August 31, 2022, at 8 medical institutions in the United States, India, and Singapore. Data were collected and analyzed from February to October 2024.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Surgeon proficiency (range, 1.0 to 7.5; higher score indicates greater proficiency) and procedure difficulty (range, \u22121.0 to 7.5; higher score indicates greater difficulty) scores. Each surgeon\u2019s procedures were sorted chronologically, then divided in half. Proficiency scores were calculated for each surgeon based on the difficulty and outcomes of their early procedures and validated using outcomes from their later procedures. Difficulty scores were calculated based on patient and injury characteristics.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The outcome of interest was procedure success, defined as digit survival at 1 month after the operation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 653 digits that were replanted or revascularized by 65 surgeons, 458 (70.1%) were successful. Mean (SD) patient age was 41.0 (15.7) years, and 571 patients (87%) were male. Difficulty scores ranged from 1.0 to 7.5, with a mean of 2.7, and were significantly higher in failed procedures than in successful procedures (mean [SD], 3.2 [1.4] vs 2.5 [1.2];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Proficiency scores ranged from \u22120.37 to 4.14, with a mean of 1.40. For each 1-point increase in proficiency score, a surgeon\u2019s future success rate increased by 7.5% (95% CI, 5.5%-8.1%;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). After adjusting for surgeon experience, difficulty score, and additional patient- and injury-level characteristics using mixed-effects logistic regression, greater surgeon proficiency score and lower difficulty score were associated with greater likelihood of individual procedure success (surgeon proficiency: odds ratio [OR], 1.46; 95% CI, 1.02 to 2.10;\n P<\/jats:italic>\n \u2009=\u2009.04; difficulty: OR, 0.70; 95% CI, 0.57 to 0.86;\n P<\/jats:italic>\n \u2009=\u2009.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This multi-institutional cohort study of patients who underwent digit replantation or revascularization found that surgeon proficiency score was associated with 1-month success. These findings suggest that national trauma referral networks should incorporate difficulty and proficiency scoring tools when coordinating patient transfers after traumatic digit amputation. Centers with high replant volume or those who are geographically well-positioned to become replant centers should aim to recruit and improve reimbursement for surgeons with high proficiency scores. Meanwhile, surgeons with low proficiency scores should seek out additional training to improve their skills.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.40453","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T15:31:39Z","timestamp":1761838299000},"page":"e2540453","source":"Crossref","is-referenced-by-count":1,"title":["Proficiency and Difficulty Scoring Tools for Finger Replantation"],"prefix":"10.1001","volume":"8","author":[{"given":"Kevin C.","family":"Chung","sequence":"first","affiliation":[{"name":"Section of Plastic Surgery, University of Michigan Medical School, Ann Arbor"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adee","family":"Heiman","sequence":"additional","affiliation":[{"name":"Section of Plastic Surgery, Michigan Medicine, Ann Arbor"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunitha","family":"Malay","sequence":"additional","affiliation":[{"name":"Section of Plastic Surgery, Michigan Medicine, Ann Arbor"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Proficiency and Difficulty Scoring Tools for Finger Replantation (PRAISE) Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily R.","family":"Geis","sequence":"additional","affiliation":[{"name":"Michigan Medicine, Ann Arbor"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Wang","sequence":"additional","affiliation":[{"name":"Michigan Medicine, Ann Arbor"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfred P.","family":"Yoon","sequence":"additional","affiliation":[{"name":"Michigan Medicine, Ann Arbor"},{"name":"Now at UC Davis Health, University of California, Davis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trista M.","family":"Benitez","sequence":"additional","affiliation":[{"name":"Michigan Medicine, Ann Arbor"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zihao","family":"Han","sequence":"additional","affiliation":[{"name":"Michigan Medicine, Ann Arbor"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aviram M.","family":"Giladi","sequence":"additional","affiliation":[{"name":"Medstar Union Memorial Hospital, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaac C.","family":"Fleming","sequence":"additional","affiliation":[{"name":"Medstar Union Memorial Hospital, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J.","family":"Gray","sequence":"additional","affiliation":[{"name":"Medstar Union Memorial Hospital, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole A.","family":"Zelenski","sequence":"additional","affiliation":[{"name":"Emory University, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael B.","family":"Gottschalk","sequence":"additional","affiliation":[{"name":"Emory University, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric R.","family":"Wagner","sequence":"additional","affiliation":[{"name":"Emory University, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karishma R.","family":"Desai","sequence":"additional","affiliation":[{"name":"Emory University, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessio M.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Emory University, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. Raja","family":"Sabapathy","sequence":"additional","affiliation":[{"name":"Ganga Hospital, Coimbatore, Tamilnadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Raja","family":"Shanmugakrishnan","sequence":"additional","affiliation":[{"name":"Ganga Hospital, Coimbatore, Tamilnadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shruthi","family":"Chandrasekar","sequence":"additional","affiliation":[{"name":"Ganga Hospital, Coimbatore, Tamilnadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua M.","family":"Adkinson","sequence":"additional","affiliation":[{"name":"Indiana University, Indianapolis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin E.","family":"Gardiner","sequence":"additional","affiliation":[{"name":"Indiana University, Indianapolis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soumen","family":"Das De","sequence":"additional","affiliation":[{"name":"National University Hospital, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep J.","family":"Sebastin","sequence":"additional","affiliation":[{"name":"National University Hospital, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hima","family":"Premnadh","sequence":"additional","affiliation":[{"name":"National University Hospital, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jocelyn","family":"Teo","sequence":"additional","affiliation":[{"name":"National University Hospital, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonu A.","family":"Jain","sequence":"additional","affiliation":[{"name":"The Ohio State University, Columbus, OH"},{"name":"Now at University of Cincinnati, Cincinnati, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kara","family":"Colvell","sequence":"additional","affiliation":[{"name":"The Ohio State University, Columbus, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip R.","family":"Ross","sequence":"additional","affiliation":[{"name":"University of Cincinnati, Cincinnati, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam C.","family":"Valenti","sequence":"additional","affiliation":[{"name":"University of Cincinnati, Cincinnati, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"issue":"25","key":"zoi251111r1","doi-asserted-by":"publisher","first-page":"1364","DOI":"10.1056\/NEJM197912203012503","article-title":"Should operations be regionalized? The empirical relation between surgical volume and mortality.","volume":"301","author":"Luft","year":"1979","journal-title":"N Engl J Med"},{"issue":"3","key":"zoi251111r2","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/S0039-6060(99)70234-5","article-title":"Effect of hospital volume on in-hospital mortality with pancreaticoduodenectomy.","volume":"125","author":"Birkmeyer","year":"1999","journal-title":"Surgery"},{"issue":"1","key":"zoi251111r3","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1097\/00000658-199501000-00005","article-title":"The effects of regionalization on cost and outcome for one general high-risk surgical procedure.","volume":"221","author":"Gordon","year":"1995","journal-title":"Ann Surg"},{"issue":"6","key":"zoi251111r4","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1016\/j.euf.2017.03.008","article-title":"Systematic review of the volume-outcome relationship for radical prostatectomy.","volume":"4","author":"Leow","year":"2018","journal-title":"Eur Urol Focus"},{"issue":"4","key":"zoi251111r5","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1097\/01.sla.0000140752.74893.24","article-title":"The relationship between hospital volume and outcome in bariatric surgery at academic medical centers.","volume":"240","author":"Nguyen","year":"2004","journal-title":"Ann Surg"},{"issue":"11","key":"zoi251111r6","doi-asserted-by":"publisher","first-page":"1845","DOI":"10.1007\/s11605-018-3849-z","article-title":"Implications of Hospital volume on costs following esophagectomy in the United States.","volume":"22","author":"Kennedy","year":"2018","journal-title":"J Gastrointest Surg"},{"issue":"15","key":"zoi251111r7","doi-asserted-by":"publisher","first-page":"1434","DOI":"10.1056\/NEJMsa1300625","article-title":"Surgical skill and complication rates after bariatric surgery.","volume":"369","author":"Birkmeyer","year":"2013","journal-title":"N Engl J Med"},{"issue":"8","key":"zoi251111r8","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1002\/bjs.9828","article-title":"Clinical validity of consultant technical skills assessment in the English National Training Programme for Laparoscopic Colorectal Surgery.","volume":"102","author":"Mackenzie","year":"2015","journal-title":"Br J Surg"},{"issue":"3","key":"zoi251111r9","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1097\/SLA.0000000000001862","article-title":"Grading of surgeon technical performance predicts postoperative pancreatic fistula for pancreaticoduodenectomy independent of patient-related variables.","volume":"264","author":"Hogg","year":"2016","journal-title":"Ann Surg"},{"issue":"9","key":"zoi251111r10","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1089\/end.2017.0284","article-title":"Surgeon performance predicts early continence after robot-assisted radical prostatectomy.","volume":"31","author":"Goldenberg","year":"2017","journal-title":"J Endourol"},{"issue":"6","key":"zoi251111r11","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1001\/jamasurg.2025.0931","article-title":"Surgical performance metrics for 1-year patient-reported outcomes after radical prostatectomy.","volume":"160","author":"Heard","year":"2025","journal-title":"JAMA Surg"},{"issue":"1","key":"zoi251111r12","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1097\/SLA.0000000000002741","article-title":"Technical performance as a predictor of clinical outcomes in laparoscopic gastric cancer surgery.","volume":"270","author":"Fecso","year":"2019","journal-title":"Ann Surg"},{"issue":"10","key":"zoi251111r13","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1001\/jamasurg.2020.3007","article-title":"Association between surgeon technical skills and patient outcomes.","volume":"155","author":"Stulberg","year":"2020","journal-title":"JAMA Surg"},{"issue":"4","key":"zoi251111r14","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1097\/SLA.0000000000003385","article-title":"Evaluating the effect of surgical skill on outcomes for laparoscopic sleeve gastrectomy: a video-based study.","volume":"273","author":"Varban","year":"2021","journal-title":"Ann Surg"},{"issue":"6","key":"zoi251111r15","doi-asserted-by":"publisher","first-page":"1374","DOI":"10.1016\/j.surg.2023.02.027","article-title":"Surgical skills assessment of pancreaticojejunostomy using a simulator may predict patient outcomes: a multicenter prospective observational study.","volume":"173","author":"Mizunuma","year":"2023","journal-title":"Surgery"},{"issue":"2","key":"zoi251111r16","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1055\/s-0038-1626689","article-title":"Predictors of digit survival following replantation: quantitative review and meta-analysis.","volume":"10","author":"Shaterian","year":"2018","journal-title":"J Hand Microsurg"},{"issue":"7","key":"zoi251111r17","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1001\/jamasurg.2019.0418","article-title":"Patient-reported and functional outcomes after revision amputation and replantation of digit amputations: the FRANCHISE multicenter international retrospective cohort study.","volume":"154","author":"Chung","year":"2019","journal-title":"JAMA Surg"},{"issue":"5","key":"zoi251111r18","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1002\/micr.30738","article-title":"Comparing digital replantation versus revision amputation patient reported outcomes for traumatic digital amputations of the hand: a systematic review and meta-analysis.","volume":"41","author":"Stone","year":"2021","journal-title":"Microsurgery"},{"issue":"4","key":"zoi251111r19","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1097\/PRS.0000000000000019","article-title":"Economic analysis of revision amputation and replantation treatment of finger amputation injuries.","volume":"133","author":"Sears","year":"2014","journal-title":"Plast Reconstr Surg"},{"issue":"10","key":"zoi251111r20","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.28765","article-title":"Variation in surgeon proficiency scores and association with digit replantation outcomes.","volume":"4","author":"Yoon","year":"2021","journal-title":"JAMA Netw Open"},{"key":"zoi251111r21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2147\/OAEM.S443219","article-title":"Microsurgical digits replantation in resource-limited setting: a retrospective study.","volume":"16","author":"Altam","year":"2024","journal-title":"Open Access Emerg Med"},{"issue":"4","key":"zoi251111r22","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1097\/PRS.0000000000008314","article-title":"A 17-year experience in hand and digit replantation at an academic center.","volume":"148","author":"Billington","year":"2021","journal-title":"Plast Reconstr Surg"},{"issue":"8","key":"zoi251111r23","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1097\/CORR.0000000000002578","article-title":"Is prolonged use of antibiotic prophylaxis and postoperative antithrombotic and antispasmodic treatments necessary after digit replantation or revascularization?","volume":"481","author":"Chen","year":"2023","journal-title":"Clin Orthop Relat Res"},{"issue":"4","key":"zoi251111r24","doi-asserted-by":"publisher","first-page":"384","DOI":"10.4103\/0019-5413.185602","article-title":"Assessment of survival rates compared according to the Tamai and Yamano classifications in fingertip replantations.","volume":"50","author":"Dadaci","year":"2016","journal-title":"Indian J Orthop"},{"issue":"4","key":"zoi251111r25","doi-asserted-by":"publisher","DOI":"10.1016\/j.hansur.2024.101758","article-title":"Psychosocial and functional impact of successful digital replantation\u2014a cohort study of 36 patients with a median follow-up of 6 years.","volume":"43","author":"DiGiovanni","year":"2024","journal-title":"Hand Surg Rehabil"},{"issue":"2","key":"zoi251111r26","doi-asserted-by":"publisher","first-page":"383","DOI":"10.52312\/jdrs.2021.32","article-title":"A four-year community hospital experience regarding procedures for the replantation and revascularization of fingers.","volume":"32","author":"G\u00fcrb\u00fcz","year":"2021","journal-title":"Jt Dis Relat Surg"},{"issue":"12","key":"zoi251111r27","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.1016\/j.jhsa.2016.09.013","article-title":"Evaluating the effect of comorbidities on the success, risk, and cost of digital replantation.","volume":"41","author":"Hustedt","year":"2016","journal-title":"J Hand Surg Am"},{"issue":"8","key":"zoi251111r28","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.66133","article-title":"The learning curve in digital replant surgery: 46 prospectively collected cases from a single surgeon over a 10-year period.","volume":"16","author":"Hustedt","year":"2024","journal-title":"Cureus"},{"key":"zoi251111r29","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.ijsu.2019.07.027","article-title":"Pre-injury level of anxiety is associated with the rate of digit replant failure: a prospective cohort study.","volume":"69","author":"Jin","year":"2019","journal-title":"Int J Surg"},{"issue":"11","key":"zoi251111r30","doi-asserted-by":"publisher","first-page":"1995","DOI":"10.1016\/j.bjps.2020.08.077","article-title":"Replantation for multiple digit amputations: a retrospective analysis of the clinical results.","volume":"73","author":"Kaneshiro","year":"2020","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"9","key":"zoi251111r31","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2018.33.e72","article-title":"The concept of door-to-surgery time in distal digital replantation.","volume":"33","author":"Kim","year":"2018","journal-title":"J Korean Med Sci"},{"issue":"2","key":"zoi251111r32","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1097\/PRS.0000000000002939","article-title":"The effect of patient age on the success rate of digital replantation.","volume":"139","author":"Kwon","year":"2017","journal-title":"Plast Reconstr Surg"},{"issue":"3","key":"zoi251111r33","doi-asserted-by":"publisher","first-page":"551e","DOI":"10.1097\/PRS.0000000000005343","article-title":"Survival after digit replantation and revascularization is not affected by the use of interpositional grafts during arterial repair.","volume":"143","author":"Lee","year":"2019","journal-title":"Plast Reconstr Surg"},{"issue":"4","key":"zoi251111r34","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1097\/PRS.0000000000002600","article-title":"The Effect of smoking on necrosis rate in digital replantation and revascularization with prostaglandin E1 therapy: a retrospective study.","volume":"138","author":"Nishijima","year":"2016","journal-title":"Plast Reconstr Surg"},{"issue":"4","key":"zoi251111r35","doi-asserted-by":"publisher","first-page":"311","DOI":"10.5505\/tjtes.2016.40040","article-title":"Eight years of clinical experience with digit replantation: Demographic characteristics and outcomes.","volume":"23","author":"Oru\u00e7","year":"2017","journal-title":"Ulus Travma Acil Cerrahi Derg"},{"key":"zoi251111r36","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.OA.24.00098","article-title":"Factors Associated with Unsuccessful Revascularization Surgery in Traumatic Upper-Extremity Amputation.","author":"Py\u00f6rny","year":"2024","journal-title":"JB JS Open Access"},{"issue":"2","key":"zoi251111r37","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1097\/PRS.0000000000005195","article-title":"The effect of increasing age on outcomes of digital revascularization or replantation.","volume":"143","author":"Retrouvey","year":"2019","journal-title":"Plast Reconstr Surg"},{"issue":"1","key":"zoi251111r38","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1007\/s00068-019-01226-x","article-title":"Digital replantation\/revascularization: predictive factors to microsurgery success-a single-center study.","volume":"47","author":"Tejedor Navarro","year":"2021","journal-title":"Eur J Trauma Emerg Surg"},{"issue":"1","key":"zoi251111r39","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1097\/PRS.0000000000010266","article-title":"Predictors for necrosis after single-digit replantation: a retrospective analysis of 946 patients.","volume":"152","author":"Wang","year":"2023","journal-title":"Plast Reconstr Surg"},{"issue":"6","key":"zoi251111r40","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1177\/1753193417703516","article-title":"Digital revascularization and replantation using the wide-awake hand surgery technique.","volume":"42","author":"Wong","year":"2017","journal-title":"J Hand Surg Eur Vol"},{"issue":"6","key":"zoi251111r41","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1016\/j.injury.2018.03.027","article-title":"The use of arteriovenous anastomosis for venous drainage during Tamai zone I fingertip replantation.","volume":"49","author":"Wu","year":"2018","journal-title":"Injury"},{"issue":"1","key":"zoi251111r42","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1177\/22925503211024767","article-title":"Determinants of success in single- and multi-digit replant.","volume":"31","author":"Zhang","year":"2023","journal-title":"Plast Surg (Oakv)"},{"issue":"4","key":"zoi251111r43","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1097\/PRS.0000000000003665","article-title":"Antithrombotic therapies in digit replantation with papaverine administration: a prospective, observational study.","volume":"140","author":"Zhu","year":"2017","journal-title":"Plast Reconstr Surg"},{"issue":"8","key":"zoi251111r44","doi-asserted-by":"publisher","first-page":"1623","DOI":"10.1007\/s00264-017-3416-3","article-title":"Pre-operative predictive factors for the survival of replanted digits.","volume":"41","author":"Zhu","year":"2017","journal-title":"Int Orthop"},{"issue":"4","key":"zoi251111r45","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5604\/01.3001.0011.8176","article-title":"Three-year (2014-2016) activity report of the Replantation Service for hand amputations in Poland.","volume":"90","author":"Zyluk","year":"2018","journal-title":"Pol Przegl Chir"},{"issue":"5","key":"zoi251111r46","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1016\/j.jhsa.2016.02.011","article-title":"The detrimental effect of decentralization in digital replantation in the United States: 15 years of evidence from the National Inpatient Sample.","volume":"41","author":"Hustedt","year":"2016","journal-title":"J Hand Surg Am"},{"issue":"3","key":"zoi251111r47","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1097\/PRS.0000000000003087","article-title":"Annual hospital volume and success of digital replantation.","volume":"139","author":"Brown","year":"2017","journal-title":"Plast Reconstr Surg"},{"issue":"2","key":"zoi251111r48","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.jhsa.2016.11.020","article-title":"Effect of hospital volume on success of thumb replantation.","volume":"42","author":"Mahmoudi","year":"2017","journal-title":"J Hand Surg Am"},{"issue":"9","key":"zoi251111r49","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1016\/j.jhsa.2021.04.011","article-title":"Geospatial inefficiencies associated with digital replantations at high-volume centers and optimal allocation model for centralization of replantations.","volume":"46","author":"O\u2019Brien","year":"2021","journal-title":"J Hand Surg Am"},{"issue":"10","key":"zoi251111r50","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1016\/j.jhsa.2018.07.021","article-title":"Finger Replantation Optimization Study (FRONT): update on national trends.","volume":"43","author":"Cho","year":"2018","journal-title":"J Hand Surg Am"},{"issue":"6","key":"zoi251111r51","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1016\/j.jamcollsurg.2021.03.018","article-title":"National population study of the effect of structure and process on outcomes of digit replantation.","volume":"232","author":"Hsu","year":"2021","journal-title":"J Am Coll Surg"},{"issue":"2","key":"zoi251111r52","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.hcl.2018.12.001","article-title":"A decade of progress toward establishing regional hand trauma centers in the United States.","volume":"35","author":"Gittings","year":"2019","journal-title":"Hand Clin"},{"issue":"24","key":"zoi251111r54","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.K.01167","article-title":"Hand and microvascular replantation call availability study: a national real-time survey of level-I and level-II trauma centers.","volume":"94","author":"Peterson","year":"2012","journal-title":"J Bone Joint Surg Am"},{"key":"zoi251111r53","first-page":"65","volume-title":"Resources for the Optimal Care of the Injured Patient: 2022 Standards","author":"American College of Surgeons","year":"2023"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2840707\/chung_2025_oi_251111_1761171557.09401.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T15:31:40Z","timestamp":1761838300000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2840707"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,30]]},"references-count":54,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.40453","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,30]]}}}