Reattaching a completely separated [replantation] part of or whole hand [or leg] has been possible due to advances in surgical techniques now. This needs thorough understanding of when to do it and how to do it on part of surgeon, which most hand surgeons are trained in. On part of patient or any attendant of patient, certain knowledge is essential to get an idea of when such a surgery is possible and how to proceed should such a severe injury occur to anyone. A common question is if any finger/s are amputated how to get them to your surgeon. This is a very critical step and may be deciding factor between success and failure. An amputated part should ideally be wrapped in a gauze [or clean towel if gauze not availbale] which is soaked in Normal saline. If such an injury happens, a patient can go to any nearby clinic/dispensary/hospital and ask them to wash amputated part with normal saline and wrap in saline soaked gauze. Then that gauze should be kept in water tight container [even a clean plastic bag will do] and that container should be kept in an ice bag. It is important not to place amputated part directly on ice, other wise that leads to chemical damage to part and replantation is not possible. When this injury happens one should try and reach a microvascular surgeon as soon as possible. The time frame for attempting replantation depends on what level of limb the injury has occured and usually is within 6-8 hrs. If prolonged beyond this time it may not be possible to reattach the part.If possible call your surgeon ahead of time so that he can ready things up to save precious time. Not all amputations can be replanted however. A clean cut sharp injury is most likely to be amenable for replantation where as a crush injury as happens in many motor vehicle accidents or industrial accidents may not be amenable for replantation even if brought in required time frame. For more information
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Meet the expert
Dr Nilesh Darawade -
Consultant Hand Surgeon Pune.