What is meant by Replantation?
Replantation is reattachment of a part that has been completely amputated from the body – there is no connection exists between the severed part and the patient.
What are the indications for Replantation?
Those with the following amputation are listed below
- Multiple digits
- Partial hand
- Any part of upper extremity of a child
- Wrist or forearm
- Elbow and above elbow level
What should be done at the site of the accident?
- The injured victim should be assessed for other major injuries.
- The victim should be removed from the accident site and place him/her in a safe area.
- Make the victim lay down and keep the injured hand in elevated position.
- Direct compression should be applied over the bleeding spot to control the active bleeding.
- The tourniquet should not be applied to control bleeding.
How to preserve the amputated Part?
Gently clean the amputated part with sterile water, cover it with gauze wrap. Put it in a watertight bag, and place that bag on ice. But don’t put the amputated part directly on ice.
How early should the replantation surgery be done?
As early as possible. The reattachment of the amputated part should be done within 4-6 hrs from the time of the accident.
How to preserve the partially amputated hand?
The sterile dressing should be applied over the injury site. Then place the ice cube containing plastic bag over the injured part.
What is the effect of cooling of the amputated part?
Cooling reduces the metabolic demand of the amputated part. The victim can be transferred from the accidental site to replant center for replantation surgery. The cooling can extend the replant surgery time quite considerably.
What is the role of the microscope in replantation Surgery?
The size of Blood vessels in the amputated ﬁngers are around 1mm in diameter. Reattachment of small blood vessels can be done by very fine sutures, that needs magnification. The operative microscope provides up to 20 times magnification. The operative microscope is essential for suturing the fine blood vessels to reestablish the blood flow to the severed part.
What are the unfavorable conditions for replantation?
- Severely crushed or mangled parts
- Amputation at multiple levels
- Amputations in patients with other serious injuries or disease
- Amputation in which severe atherosclerotic vessels
- Amputations with mentally unstable patients
Other than finger and hand replant, any other amputated body parts can be replanted?
- Avulsion of the scalp – complete detachment of hair-bearing scalp skin
- Amputation of the foot and leg
- Amputation of male genital organ
If the amputated body part are preserved well and the patient’s general condition is fit to undergo major replantation surgery, above mentioned amputated body part can be replanted.