Replantation is surgery to reattach a completely severed body part, commonly a finger or toe. Arms, legs, scalps, and other tissues can be reattached in surgery as well. This procedure may be a possibility when the detached body part is still in good condition and the patient will have more functionality after surgery than with a prosthesis. Recovery times and prognoses vary, depending on the situation, and patients may want to discuss their options thoroughly with a surgeon before making a decision on how to proceed.
Accidental amputation tends to be traumatic and may damage tissues beyond repair. Someone who loses a leg in a traffic accident, for example, may have such badly crushed tissues and bones that replantation is not possible. Conversely, accidentally removing a finger with a cleaver may allow for replantation, especially if the severed finger is immediately put on ice and transported with the patient to a medical facility.
In a replantation procedure, the patient may receive general or local anesthesia. First, the surgeon prepares the site. The doctor trims away damaged tissue, washes the severed tissue very well to remove dirt, bacteria, and other sources of infection, and examines the ends to make sure the replant will be viable. Then, the surgeon stitches together nerves, tendons, skin, and so forth and checks to see if the circulation reaches the area, causing the tissue to pink up as blood flows through.
It may take weeks or months for patients to recover and they usually do not experience a full restoration of function. A replanted extremity may be shorter and can have significant scarring and a more limited range of motion. Fine motor tasks can be difficult and patients may experience pain and soreness during the recovery period. Physical therapy can help patients develop strength and dexterity in the reattached limb, and the surgeon will also follow up to check for signs of inflammation and infection.
Sometimes, the surgery fails. The limb, or parts of it, may die because they do not receive adequate circulation. Muscles can atrophy when nerves do not heal, or patients may have limited movement. In some cases, it may be necessary to have a follow-up surgery to correct issues, or to amputate a failed replantation before it causes more problems for the patient.
If a surgeon believes replantation may cause chronic pain or thinks a prosthesis would be more suitable, she will not recommend this procedure. This generally involves cleaning up the site of the amputation in surgery, clearing dead and damaged tissue and making sure it is appropriately prepared to receive a prosthesis after the patient heals from the initial trauma.
