Replantation in the mutilated hand

Bradon J. Wilhelmi, W. P.Andrew Lee, Geert I. Pagensteert, James W. May

Research output: Contribution to journalReview article

30 Scopus citations

Abstract

With the evolution of surgical techniques and scientific technology, replantation has become more refined, establishing specific indications for replantation, rituals for preparation, efficient techniques to ultimately minimize ischemia times, improved survival rates, guidelines for postoperative care, strategies for treating complications, and goals for outcomes. Patient satisfaction hinges on their level of expectation as defined and explained in the preoperative discussion and informed consent. Studies have demonstrated patients can be expected to achieve 50% function and 50% sensation of the replanted part. Initially all that was amputated was replanted, as surgeons adopted the philosophy of George C. Ross (1843-1892): "Any fool can cut off an arm or leg but it takes a surgeon to save one." Forty years after the first replant (1962-2002), however, we recognize the ultimate goal: not merely to preserve all living tissue through nonselective replantation, but rather to preserve one's quality of life by improving their function and appearance. This objective to care for the patient with the intent to optimize function and appearance is important not only to the replantation of amputations but to all mutilated hand injuries.

Original languageEnglish (US)
Pages (from-to)89-120
Number of pages32
JournalHand Clinics
Volume19
Issue number1
DOIs
Publication statusPublished - Feb 2003
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Wilhelmi, B. J., Lee, W. P. A., Pagensteert, G. I., & May, J. W. (2003). Replantation in the mutilated hand. Hand Clinics, 19(1), 89-120. https://doi.org/10.1016/S0749-0712(02)00137-3