Finger amputation

Indications for Replantation

1. Thumb
2. Multiple digits
3. Amputation level between palm and distal forearm
4. Distal to FDS insertion
5. Amputations in children

Contraindications

1. Severely crushed or mangled parts
2. Prolonged warm ischemia time
3. Single digit
4. Severe contamination
5. Age >60, poor health, atherosclerotic disease
6. Avulsion injury
7. 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

1. Irrigate amputated part
2. Place moist, sterile gauze around amputated part
3. Place in water tight container in ice water
4. X-ray limb and part
5. Tdap
6. Abx
   1. 1st generation cephalosporin + gentamicin
7. Consult surgery

See Also

• High-Pressure Injection Injury

Source

DeBonis 7/09 Adapted Burbulys