{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:23:19Z","timestamp":1788441799023,"version":"build-2803163510"},"reference-count":20,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T00:00:00Z","timestamp":1675382400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Individuals with end-stage renal disease (ESRD) and fingertip wounds are at high risk of poor wound healing, ultimately requiring amputations. Optimal performance of upper extremity amputation (UEA) in patients with ESRD is important to decrease complications and minimize total operative procedures needed. This study evaluated outcomes of UEA in patients with ESRD and described risk factors predisposing patients to complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective analysis of patients receiving nontraumatic UEA for fingertip wounds was conducted, stratified by patients with and without ESRD. Demographics, comorbidities, complications, and hospital course were analyzed between groups for differences. Subanalysis of patients with ESRD was conducted to characterize operative course and predictors of complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 132 patients were included, 106 controls and 26 with ESRD. Compared with controls, patients with ESRD required more amputations (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and total operations (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) to achieve wound healing. Patients with ESRD experienced higher rates of postoperative complications (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Predictors for complications in patients with ESRD were comorbid diabetes (odds ratio [OR]: 45; 95% confidence interval [CI], 1.7-1226.9), vascular disease (OR: 30; 95% CI, 2-441.8), arterial calcification (OR: 18; 95% CI, 1.56-207.5), and presence of a hemodialysis shunt in the affected arm (OR: 18; 95% CI, 1.56-207.5). Within patients with ESRD, initial amputation at, or proximal to, the metacarpophalangeal joint (MCPJ) led to fewer amputations (1.2 vs 2.19,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .04) and fewer total operative procedures (4.1 vs 6.6,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .03), compared with initial amputation distal to the MCPJ.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In nontraumatic fingertip wounds, patients with ESRD had worse operative outcomes than patients without ESRD. More aggressive management of fingertip wounds using earlier and more proximal initial amputations may expedite wound healing in certain high-risk patients with ESRD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447231151261","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T05:53:47Z","timestamp":1675403627000},"page":"814-822","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Refining Treatment Strategies in Patients With Fingertip Wounds and End-Stage Renal Disease"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2496-9687","authenticated-orcid":false,"given":"Neel","family":"Vishwanath","sequence":"first","affiliation":[{"name":"The Warren Alpert Medical School of Brown University, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Hu","sequence":"additional","affiliation":[{"name":"The Warren Alpert Medical School of Brown University, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5085-5045","authenticated-orcid":false,"given":"Vinay","family":"Rao","sequence":"additional","affiliation":[{"name":"The Warren Alpert Medical School of Brown University, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Crozier","sequence":"additional","affiliation":[{"name":"The Warren Alpert Medical School of Brown University, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0305-877X","authenticated-orcid":false,"given":"Loree K.","family":"Kalliainen","sequence":"additional","affiliation":[{"name":"The Warren Alpert Medical School of Brown University, Providence, RI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2018.03.053."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1142\/S2424835519500462."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2020.03.008."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1753193420981871."},{"issue":"1","key":"e_1_3_2_6_2","first-page":"33","article-title":"Outcomes of patients with atherosclerotic upper extremity tissue loss","volume":"39","author":"Zhang WW","year":"2005","unstructured":"Zhang WW, Harris LM, Shenoy SS, et al. 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