Replantation

The advent of microsurgery has profoundly impacted the field of hand surgery, providing a means for precise coaptation of vessel and nerve, consequently allowing salvage of amputated parts. Despite these technical advances, the overall goal of management following amputation remains the same – provide the most functional outcome for each patient’s individual occupational and vocational needs. Therefore, it is not only the surgeon’s task to competently perform a replantation when necessary, but also understand in which patients and injuries a revision amputation may ultimately provide a superior outcome. Candidacy for replantation should be resolved by way of a focused history, physical examination, radiographic imaging, and a thorough discussion regarding the need for rehabilitation and potential for secondary procedures. Ultimately, there are very few absolute indications or contraindications for replantation, and each case must be considered on an individual basis. This review contains 3 figures, 4 tables, and 28 references. Key words: amputation, upper extremity, hand, digit, salvage, replant, replantation, revascularization, surgery of the hand