Plastic, Hand & Microsurgery>>Replantation Surgery>>What is Replantation Surgery

What is replantation surgery?

Replantation is a microsurgical procedure where by a totally amputated body part is rejoined.  In case of limbs it involves preparing the cut ends, stabilizing the bone, and joining blood vessels, nerves and tendons. It is the best form of reconstruction.  Major replantation centres need good infrastructure and trained personnel available at all times.  The Plastic Surgery department at Ganga Hospital is one of the leading replantation centres in this part of the world. 

How to bring the amputated parts?

Time is crucial in replantation surgery.  Without blood supply tissues of the body degrade.  This degradation can be slowed down by properly storing the amputated part during transport to the hospital. 

The amputated part must be put in to a plastic bag. It is good to tightly seal the plastic bag with a knot.  Place this plastic bag containing the amputated part inside another container and put ice cubes all around the plastic bag. 

DO NOT - Put the part and ice cubes together in the same bag.
DO NOT - Put the amputated part into any solution like water, glucose or formalin.

What to do with the patient?

The injured end may be bleeding or might have stopped bleeding when you see the patient.  In either case cover that area with a clean cloth or bandage if available and give a firm dressing. Look out for other injuries. Life threatening injuries must first be attended to.  As early as possible shift the patient to the replantation centre. In case there should be a delay, the amputated part must be properly stored and could be sent to the replantation centre.  Assessment of the possibility of replantation and preparation of the amputated part could be done.

DO NOT – give the patient anything to eat or drink during transport.  It is good to have an empty stomach when one has to undergo a surgical procedure under anaesthesia. 

How soon should the patient reach the replantation centre?

As early as possible is the answer.  Longer the time the amputated part is without blood supply, more is the degradation of the tissues.  Various tissues degrade at different speeds.  Muscles degrade faster. If the products of degradation enter the general circulation it is very dangerous to the life of the patient.  Hence, major amputations which contain lot of muscles (forearm, arm, leg) must be rejoined very quickly – usually within 6 hours. 
Based on the same principle, amputations of the hand distal to the wrist, fingers and thumb can be rejoined at longer intervals when compared to an arm amputation. So if an important part like the thumb is amputated, provided it is properly stored after injury, patient can travel long distances to get the replantation done.  Well stored finger tips have been rejoined even after 48 hours. 

It is better to inform the replantation centre early so that the team is better prepared.
In the event of emergency, Please call -0422 - 2485000