Some amputations are planned, such as when a patient with diabetes must lose a foot due to an incurable infection. Others happen suddenly and unintentionally, such as in an industrial, construction, or car accident. The aftermath of a serious accident is chaotic and messy. A survivor’s first priorities are to call 911, and apply direct pressure to the wound. The trauma scene cleanup professionals in Orlando can sanitize the site, but the paramedics will take the amputated body part to the hospital. It might be possible for it to be reattached.
What to Do with a Severed Body Part
Severed digits and limbs may be rinsed with clean water if available, but should not be scrubbed. The body part should be wrapped in sterile gauze or the cleanest cloth available at the accident scene or crime site. It should then be placed into a sealable plastic bag or other waterproof container, and then placed on ice. Do not allow the amputated body part to come into direct contact with ice, and do not cover it with ice.
When Replantation Is Possible
A body part’s ischemia tolerance is the length of time it may still be viable despite lacking blood circulation. The ischemia tolerance of digits is about eight hours, and for limbs, it’s four to six hours. However, replantation should be attempted as soon as possible if the patient is a good candidate for it. Trauma surgeons are more likely to attempt replantation if any of the following criteria apply:
- The amputation was a clean cut, rather than a crush injury
- The body part was well-preserved
- The loss of the body part will result in significant disability
- The patient is otherwise in reasonable health, and can comply with recovery requirements
- The patient is a child
- The limb is an arm, rather than a leg
In almost every case, surgeons will attempt replantation on a child, even if success isn’t likely. Surgeons are more likely to attempt to replant thumbs, rather than fingers, because prosthetic thumbs are relatively inadequate. Replantation is more likely with an upper body part, as prosthetics for feet and legs often provide better function than a replanted foot or leg.
How Replantation Is Attempted
When an accident survivor is a good candidate for a replantation attempt, the surgical team will begin by examining X-rays to plan the operation, administering antibiotics and a tetanus vaccine, and scrutinizing the integrity of the severed blood vessels. Then, the surgeon will reattach the following, in order: bones, tendons, nerves, arteries, and veins.