Finger amputation

Indications for Replantation

• Thumb

• Multiple digits

• Amputation level between palm and distal forearm

• Distal to FDS insertion

• Amputations in healthy children

Contraindications

• Severely crushed or mangled parts

• Prolonged warm ischemia time

• Single digit

• Severe contamination

• Age >60, poor health, atherosclerotic disease

• Avulsion injury

• Lower extremity amputations

Warm Ischemia

• 12 hours for digit; 6 hours for muscle bearing extremity

Cold Ischemia

• 24 hours for digit; 12 hours for a muscle bearing extremity

Treatment

• Irrigate amputated part
• Place moist, sterile gauze around amputated part
• Place in water tight container in ice water

• Xray limb and part

• Tdap
• Abx ppx

• Consult surgery

Source

DeBonis 7/09 Adapted Burbulys