Finger amputation

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Indications for Replantation

Thumb

Multiple digit

Amputation level between palm and distal forearm

DISTAL to FDS insertion

Amputations in healthy 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

Mental instability


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

Moist, sterile gauze around amputated part, placed in water tight container in ice water

Xray limb and part

Tdap

Abx PPx

Consult surgery


Source

DeBonis 7/09 Adapted Burbulys