How much do you know about “replantation of severed fingers”?

This is the 4884th article of Da Yi Xiao Hu

Since the establishment of our finger replantation center, we have completed many finger replantation operations, but I found that many patients, their families, colleagues, etc. do not understand the "finger replantation" technology well enough.

Today I would like to share with you some basic knowledge about the “replantation of severed fingers” technology.

What is "replantation of severed fingers"? As the name suggests, it is to replant the fingers that have been cut off from the human body. Why can't many hospitals perform this operation routinely? Because it requires the re-anastomosis of severed phalanges, blood vessels, nerves and tendons, especially the reconstruction of the blood circulation of the severed fingers to keep them alive. This not only requires a long operation time, but also requires delicate operation under a microscope, requiring strong energy, eyesight and microsurgery skills. Therefore, it is difficult to perform this operation routinely in many hospitals.

What is the survival rate of “replantation of severed fingers”?

The survival rate of finger replantation is related to many factors, including the time of injury, the degree of finger damage, surgical technique, and personal condition.

Generally speaking, the shorter the time of finger separation and the better the preservation conditions, the higher the survival probability; the survival probability of a finger directly severed is higher than that of a crushed or avulsed finger; a finger replantation center with mature surgical techniques has an experienced medical team, and superb surgical techniques and perfect perioperative management significantly improve the survival probability. In addition, whether the patient has concurrent infection, a long-term smoking history, underlying diseases such as diabetes, depression and refusal to cooperate with active treatment (some patients with severed fingers are caused by self-harm) will also affect the survival rate of the patient's fingers.

How long does it take to observe a replanted finger to ensure complete survival?

Generally, at least 5-7 days of observation are required, and some may even need to be extended to 14 days or longer. During this period, you must strictly follow the doctor's instructions, place a catheter, and rest in bed, keep the affected limb elevated and exposed to a heat lamp, avoid smoking, drinking, and eating a light diet, and rest peacefully to avoid depression or excitement. If a finger crisis occurs, you must actively cooperate with the doctor's treatment to ensure the survival of the finger as much as possible. If the finger unfortunately cannot survive, don't be frustrated or discouraged. You can also use remedial measures such as transposition flap surgery or thumb reconstruction with a big toe nail flap.

Why does the replanted finger feel different from the original one?

Almost all patients can feel that the fingers that survive replantation are different from the original ones. Although the blood vessels, nerves and tendons have been reconstructed, the functions of the anastomosed tendons and nerves are indeed different from the original ones, and there are a series of symptoms such as tendon adhesion, local skin numbness, and decreased sensation. Can these functions be improved? Through medication and a series of rehabilitation exercises, the symptoms can be partially improved, but it is almost impossible to fully restore the original functional state.

What if the entire palm or the entire sole of the foot is broken off, can it be reattached?

In a more mature replantation center, as long as the preservation conditions, wound surface conditions and replantation time window allow, it is still entirely possible to successfully replant the entire palm or the entire sole of the foot, and even the entire forearm or the entire foot. However, like the replanted fingers, the function of the entire palm or forearm, and the function of the entire foot are still significantly affected. However, given the limitations of current prosthetic technology (especially forearm prosthetic technology), the significance of this operation is still very huge.

The above is some basic knowledge about “finger replantation”. I hope patients can gain something from this article.

Author: Shanghai Tongji Hospital Severed Finger Replantation Center

Ju Yufeng