Replantation of digits is the reattachment of fingers or toes that have been completely cut off, or amputated.

Who is a candidate for the procedure?

Someone whose fingers or toes have been amputated is a candidate for this procedure. It is usually an emergency procedure, done within a few hours of the injury.

How is the procedure performed?

The amputated digits are kept cool before surgery. This is done by wrapping the digits in gauze moistened with saline, or a salt solution. The digits and gauze are placed inside a bag and set on ice to keep them cool. This helps to preserve the amputated parts. For best results, the replantation should be done within 4 to 6 hours of the injury.

Replantation of digits can be performed under general anesthesia. This means that the person is put to sleep with medication. The surgery may also be done using a nerve block, or "numbing" medication. In this case, the person is awake but has no pain.

The bone ends of the affected finger or toe are shortened. This is done to decrease tension on the repaired arteries, veins, and nerves. Wires may be used to stabilize the bones. The tendons are then repaired. Because they are so small, the nerves and vessels are repaired using a microscope. Once the repair is done, the hand or foot is wrapped in a dressing. A cast may be applied after surgery to protect the replanted digit.