Replantation-Case - Replantation

Case - Replantation
Pdf Summary
Replantation is the process of reattaching an amputated body part, such as a thumb, back to its original location. In the case of a 35-year-old electrician who suffered a complete amputation of his nondominant thumb, the steps in managing this condition include preparation of the amputated part on a back table, identification of arteries, veins, nerves, and tendons, and bone shortening and stabilization with k wires. The extensor tendon, dorsal vein, flexor tendon, digital nerves, and ulnar digital artery are all repaired during the procedure.<br /><br />Replantation is indicated when it is likely that the replanted part will function better than other reconstructive procedures. This is often the case for thumbs, multiple digits, children, and proximal amputations. However, there are some contraindications to replantation, such as multilevel injuries, severe crush injuries, a patient unable to tolerate a prolonged surgical procedure, and a single digit amputation in zone II.<br /><br />There is no definitive recommendation for anticoagulation during the procedure, so it is up to the surgeon's preference. Post-operative monitoring includes the use of a pulse oximeter and clinical examination of temperature and cap refill. Pale color indicates arterial insufficiency, while dusky or congested color indicates venous occlusion.<br /><br />The first goal of replantation is survival, followed by rehabilitation to make the digit functional. It is important to note that patients may experience cold intolerance, which can improve over time but may not fully resolve.
Keywords
Replantation
amputated body part
thumb
reattaching
preparation
arteries
veins
nerves
tendons
bone shortening