ARM, HAND AND FINGER REPLANTATION SURGERY

Replantation Surgery is the surgical reattachment of a part of a body like finger, hand or arm that has been completely cut from a person’s body. The goal of replantation surgery is to give the patient back as much of the useful tissue as possible.

In some cases, a replantation of amputated body part is not possible because it is too much damaged. If the lost part cannot be reattached, the surgeon may still offer to clean, smooth and cover the cut end to give patient a smooth and faster recovery.

HOW TO PRESERVE THE AMPUTATED BODY PART

  • Gently rinse off dirt and debris with clean water, if possible.
  • Wrap the amputated part in a dry, sterile gauze or clean cloth.
  • Put the wrapped part in a plastic bag or waterproof container.
  • Place the plastic bag or waterproof container on ice. The goal is to keep the amputated part cool but not to cause more damage from the cold ice. Do not cover the part with ice or put it directly into ice water.

REPLANTATION SURGERY

In suitable cases amputated parts can be successfully replanted. The success of the replantation surgery depends on:

  • What body part was amputated?
  • The condition of the amputated part.
  • The time since the amputation and receiving medical care.
  • The general health of the injured person.

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PROCEDURE OF REPLANTATION SURGERY

Step 1: The damaged tissue is removed from both the amputated part and the body.

Step 2: Bone ends are trimmed and joined together with fixation like pins, wires, or plates and screws. This holds the part in place.

Step 3: Muscles, tendons, arteries, nerves and veins are then repaired.

Step 4: The wound is closed with the assistance of skin grafts or soft tissue flaps if necessary.

RECOVERY

The replanted part is carefully monitored for several days to make sure that circulation is maintained. Following an initial healing period of approximately 6 weeks, intensive physiotherapy begins which may last up to a year and additional surgical procedures may be required.

Many factors play an important role in the replantation surgery recovery process.

  1. Avoid smoking, as it may cause loss of blood flow to the replanted part.
  2. Elevation of the replanted part above heart level to increase circulation.
  3. Younger patients have a better chance of quick nerve recovery and may regain more feeling and movement in the replanted part.
  4. Level of injury. Distal replants have better outcome
  5. Joint vs. non-joint injury. More function will return for patients who have not injured a joint.
  6. Type of injury: clean cut vs. crushed body part. A cleanly severed part usually regains better function after replantation than one that crushed amputated part

REHABILITATION

  • For Replant Patients

    • Physical therapy and temporary splinting are important for the replantation surgery recovery process. From the beginning, splint age is used to protect the newly repaired tendons, nerves and vessels but allow the patient protective movements of the replanted part.
    • This limited motion therapy helps keep the joints and muscles mobile, and minimize the scar formation.
  • For Amputees

    • Therapy and rehabilitation also play an important role in recovery of a complete amputation. For the missing part, a prosthesis may be worn.

WILL ADDITIONAL SURGERY BE NECESSARY AFTER REPLANTATION SURGERY?

After replantation, some patients may need additional surgery at a later time to improve function.

Common procedures of replantation surgery done are:

  • Tenolysis: release tendons from scar tissue.
  • Capsulotomy: releases stiff joints.
  • Tendon or muscle transfer: transferring tendons or muscles to another spot so that they can work in an area with damaged tendons and muscles
  • Nerve grafting: replaces a scarred nerve or a gap in the nerves to improve the sensations of replanted part.

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