Finger amputation: Difference between revisions
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#Multiple digits | #Multiple digits | ||
#Amputation level between palm and distal forearm | #Amputation level between palm and distal forearm | ||
# | #Proximal to FDS insertion | ||
#Amputations in children | #Amputations in children | ||
==Contraindications== | ==Contraindications== | ||
Revision as of 02:58, 28 March 2012
Indications for Replantation
- Thumb
- Multiple digits
- Amputation level between palm and distal forearm
- Proximal to FDS insertion
- Amputations in children
Contraindications
- Severely crushed or mangled parts
- Prolonged warm ischemia time
- Single digit
- Severe contamination
- Age >60, poor health, atherosclerotic disease
- Avulsion injury
- Lower extremity amputations
Warm Ischemia
- 12 hours for digit; 6 hours for muscle bearing extremity
Cold Ischemia
- 24 hours for digit; 12 hours for a muscle bearing extremity
Treatment
- Irrigate amputated part
- Place moist, sterile gauze around amputated part
- Place in water tight container in ice water
- X-ray limb and part
- Tdap
- Abx
- 1st generation cephalosporin + gentamicin
- Consult surgery
See Also
Source
DeBonis 7/09 Adapted Burbulys