Finger amputation
Indications for Replantation
Thumb
Multiple digit
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
Mental instability
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
Moist, sterile gauze around amputated part, placed in water tight container in ice water
Xray limb and part
Tdap
Abx PPx
Consult surgery
Source
DeBonis 7/09 Adapted Burbulys
