Replantation of digits is the reattachment of fingers or toes that have been completely cut off (amputated) as the result of a traumatic injury.
Someone whose fingers or toes have been amputated as the result of an injury is a candidate for this procedure. It is usually an emergency procedure, done within a few hours of the injury.
The amputated digits are kept cool before surgery. This is done by wrapping the digits in gauze moistened with saline, or a salt solution. The digits and gauze are placed inside a bag and set on ice to keep them cool. This helps to preserve the amputated parts. For best results, the replantation should be done within 4 to 6 hours of the injury.
Replantation of digits can be performed under general anesthesia. This means that the person is put to sleep with medication, feels no pain, and has no awareness of the operation. The surgery may also be done using a nerve block, or "numbing" medication. In this case, the person is awake but has no pain in the affected part.
The bone ends of the affected finger or toe are shortened. This is done to decrease tension on the repaired arteries, veins, and nerves. Wires may be used to stabilize the bones. The tendons are then repaired. Because they are so small, the nerves and vessels are repaired using a microscope. Once the repair is done, the hand or foot is wrapped in a dressing. A cast may be applied after surgery to protect the replanted digit.
Operative Hand Surgery, Green, 1993
Current Surgical Diagnosis and Treatment, Way, 1994