Upper limb replantation: How I do it

Abstract

Replantation is a resource-consuming and expensive activity. The mean operation time is around 6 hours for one finger and it is not unusual for a multiple-finger replantation to take more than 24 hours. In most industrialized countries replantation surgery has become routine. It is reasonable to demand clear indications for this kind of surgery, but unfortunately these cannot yet be expressed in well documented distinct points. The patient, the mechanism of injury and the level and extent of amputation must be considered to balance the risks and costs of replantation against possible benefits. This is true also of recirculation for survival of partially amputated parts with interrupted circulation. A better result can be expected after recirculation than after replantation.