Although replantation has improved many lives, not all people with an experience of an amputation benefit from it, or are candidates for replantation.
The goal of re-implantation or re-attachment surgery of limbs (fingers to be more accurate), after a traumatic amputation, is the successful restoration of function of the fingers. Returning only the circulation to the amputated part does not in itself define success. Traumatic hand and digit injuries can be difficult and complicated to reconstruct, and in principalisation of plastic surgery, replacing defects with similar tissue results in the best outcomes.
With advanced microsurgical techniques, re-implantation has become more common and can be performed with high success rates both aesthetically and functionally. Replantation procedures have been performed on amputated fingers, hands, forearms, feet, amputated ears, avulsed scalp injuries, an amputated face, lower extremities, amputated genitals as well.
An amputation is a complete separation of a part of the body and can occur at any level in the hand or the arm.
Diagnosis is usually obvious on the visualisation of the injury, but an X-ray is taken to look at the extent of the bone damage.
Skin grafting or alternative soft tissue replacement options such as local flaps are discussed based and recommended to optimise the healing time and functional outcome based on the specification of the injury. If the injury results in exposed bone, the tissue around the wound may not be enough to stitch and close it directly. This might need the bone to be shortened to allow for wound closure.
Although this probably seems detrimental for long-term use of the hand, most individuals with partial amputation injuries involving the fingers have excellent long-term functional outcomes and use of their injured hand. A successful replantation of fingers often requires critical and accurate repairing of blood vessels, nerves, and tendons.
The decision to get a re-implantation surgery for a severed part is influenced by factors, including the importance of that part, the degree of the injury, the return of functionality, and the mechanism of injury. The function of the hand is severely compromised if the thumb or any of the other fingers are not present. Functional outcomes following replantation surgeries may vary with the level of injury.