Major Amputations at the Arm and Forearm Level: Replantation Strategy and Technique

Abstract

Amputations at the arm and forearm level are an emergency frequently associated with potentially fatal concomitant injuries. The loss of a big segment of the upper limb is, however, a source of high disability for the patients, so every effort to replant the severed part should be made. First of all, the patients have to be evaluated by the anesthesiologist to understand the risk of replantation. Many different characteristics concerning the mechanism of trauma, ischemia time, and

Review of Replantation Services from a Level One Trauma Center in India

“…22 Centers in United Kingdom performed 5 cases per center per year, 12 to 24 cases in the United States, and 24 to 36 cases in China. 12,23,24 In our center, a higher patient load and high attempt rate (65%) resulted in 77 replants being performed in 14 months. Furthermore, financial implications were minimal for patients as our hospital is government-funded, making replantation accessible to low-earning individuals.…”

“…This result may be attributable to selective use of heparin in relatively suboptimal cases. 12,38 We recommend limited use of anticoagulation in proximal extremity replants, scalp replants, and crushed or avulsion amputations of digits.…”

“…First-generation cephalosporins or amoxicillin-clavulanic acid were used in clean-cut replantation and aminoglycosides, in addition, were administered in contaminated cases. 6,12,13…”