With the technical advances that we are afforded in the 21st century, it is now possible to re-attach many amputated limbs. However, re-attachment is not always in the patient's best interest as function and appearance of the hand may be better without reattachment. The decision must be made based on the individual as a whole, and depend on the level and mechanism of the injury and the patient's age and occupation. If re-attachment is to be performed, it must be done with minimal delay. Below are some guidelines, but every situation is evaluated separately.
- Best hope for a successful re-attachment is when the amputation is sharp or clean. Re-attachment of crush amputations are not as successful.
- Hand and finger re-attachments are more successful than those of the upper arm and shoulder.
- Age is a factor; children do better than adults.
Indications for Replantation
- Injury to multiple digits or thumb
- Amputations in children, even single fingers
- Clean amputations at the hand wrist and forearm level
Not Indicated for Replantation
- Crush amputations
- Single finger amputations in adults, unless professional or social factors are present
- Heavily contaminated amputations
- Amputations that occurred in conjunction with more severe injuries that require more immediate attention
Preparing an Amputated Limb for Transportation
Wrap the amputated limb in a wet towel or gauze. Place the wrapped limb in a plastic bag. Then, place the bag on ice. DO NOT put the amputated limb directly on ice.