Summary
Replantation of an amputation is no longer a difficult technical problem. Indeed,
the experience gathered over the last few decades, right from the first concepts posed
by the pioneers up to the present era and the improved technical aids, all go to suggest
that the majority of amputated segments may now be reconstructed. However, what we
really want from a replant is not just survival but function. Indications for replantations
must follow careful and objective patient selection together with the evaluation of
type and site of lesion and possible complications. Furthermore, the important role
of emergency organization in this type of surgery is to be emphasized. Nowadays, clean
cut injuries are rarer and are being substituted by high energy trauma which may produce
extensive tissue lesions that increase complications and lead to poor functional results.
Consequently, some authors were induced to describe evaluation systems for decision
making which still present problems which are in part due to the large number of parameters
to be taken into consideration as well as to the complex functionality of the upper
limb. This led us to evaluate our case series of 52 major replantations of the upper
limb over the last 10 years and to compare it with other published series. The best
form of reconstruction following total amputation of a major limb segment is still
its replantation. The highly significant increase in the quality of life is able to
justify the higher social costs and the number of operations required.
Keywords
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Article info
Publication history
Published online: May 26, 2007
Accepted:
February 21,
2007
Received:
October 29,
2006
Identification
Copyright
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
