Replantation is a surgical procedure performed to reattach a severed body part such as a finger, toe or hand, with the goal of restoring the appearance and function of the body part to its full potential. It is a complex surgery that involves the repair and reattachment of the amputated region along with the various structures supporting it. This is made possible by advances in microsurgery, where surgery is performed using operating microscopes and fine sutures.
A clean cut with minimal tissue damage responds well to replantation. If there is excessive tissue damage, or the replanted part would not function well, your doctor may suggest an artificial replacement or prosthesis. Your doctor will review your medical history and closely examine your injury before discussing whether you are a good candidate for replantation and what to expect from the procedure.
The procedure requires great skill and involves the removal of any dead, damaged tissue, followed by the trimming of bone ends to easily approximate the tissues. Arteries, veins, nerves, muscles and tendons are carefully sutured together. Tissue and skin grafts may be transferred from other parts of the body when there is a great loss of tissue or skin.
Replantation procedures usually require a long rehabilitation period to allow the motor and sensory nerves to gradually grow back. Avoid smoking as it reduces circulation to the replanted area preventing healing. You may need to wear a brace to protect the repaired area and allow movement. Physical therapy is very important to improve strength, flexibility and muscle control, and prevent stiffness and scar formation. However, even after recovery, you may not be able to perform all the tasks you used to before the injury. In order to continue with specific functions and hobbies, you may be trained to use assistive devices.
Additional surgery is occasionally necessary to improve function by freeing tendons from scar tissue, releasing locked joints, transferring more tendons, muscles and nerves to further improve function, or amputating the affected region if it fails to function normally.
Replantation has better outcomes if minimal time has elapsed since the injury, there is less wound contamination, and you are a young patient with no diseases such as diabetes that would affect wound healing.