What is a Re-implantation procedure?
Re-implantation is a reattachment surgery of a body part, which has been amputated due to a mishap or trauma. This helps in regaining the sensation of the amputated elements, through the repair of nerves and vessels (artery & vein) to revive full functionality and appearance. It is usually done within a few hours of the amputation of a body part. Replantation can be performed upper and lower limbs to ensure correction and of parts.
Common Re-implantation of upper & lower limbs:
- Fingers
- Hands
- Forearms
- Arms
- wrist
- Toes
- Feet
- Legs
Preservation methods:
- Amputated parts should be immediately stored in a sterile bag, which can be sealed and preserved in ice-cold water/temperature until the patient reaches a hospital to perform re-implantation.
- The amputated body part or piece shouldn’t be stored with the help of dry ice because it can lead to freezing of the tissue death which mainly makes it non-viable.
- Parts without major muscles like fingers can be preserved for many hours. Major muscle parts such as arms need to be re-attached and revascularized within 6–8 hours to have a viable limb.
- The outcome of major limb replantation can be foretold by the potassium level of blood which flows out of the replanted part after revascularization.
- A high level of potassium is an indicator of muscle and tissue death.
The procedure of Re-implantation in hands and fingers:
- Temporary arterial shunting in major replantation. Not necessary in parts without skeletal muscle.
- Flexor tendon/muscle repair.
- Extensor tendon/muscle repair (this may be referred to just before venous repair, so the hand doesn’t need to be turned over and turned back again).
- Venous repair (with vein grafts if necessary).
- Skin grafting or local flap if necessary.
- Nerve repair.
- Arterial repair (with vein grafts if necessary).
- Microvascular transplant coverage of major wounds if necessary after improved potential part survival.
