Replantation

What is replantation?

Replantation is the reattachment of a completely severed body part. Most commonly the severed part is a finger, hand, forearm or arm. Other areas that have been reattached involve the lower limb, face, tongue, ear, scalp or penis.

When Is replantation performed?

Replantation is ideally performed for a thumb amputation, multi-digit amputation, a digit amputation in a child or a finger distal to the PIP joint. Contraindications are prolonged warm ischemia time, segmental loss, and diffuse crush or severe avulsion injuries, or a single digit proximal to the PIP joint. All major amputations involving the entire hand to the shoulder are usually attempted.

How is replantation performed?

The damaged tissue is removed from both the amputated part and the body. The wounds are thoroughly cleansed. The bones are trimmed slightly also allowing slight shortening which benefits repair of the remaining structures. The bones are joined together with fixation. Arteries, veins, nerves and tendons/muscles are repaired. The wound is closed with the assistance of skin grafts or soft tissue flaps if necessary. The reattached part is carefully monitored for several days to make sure that circulation is maintained. Following an initial healing period of approximately 6 weeks, intensive therapy begins which may last up to a year and additional surgical procedures may be required.