Digital Replantation

Digital replantation surgery involves using a microscope to reconnect blood vessels and nerves. This technique has evolved over time, leading to improved treatment outcomes. When an injury results in the loss of a finger, the patient or the person accompanying them to the hospital should bring all the missing parts. Before arriving at the hospital, the missing parts should be cleaned with clean water and wrapped in clean cloth soaked in clean water. Then, the wrapped parts should be placed in a plastic bag, sealed tightly, and immersed in ice water (without direct contact between the missing parts and the ice water).

For the injured finger (the patient's hand), a clean cloth should be tightly wrapped around the wound to stop bleeding. Avoid using tourniquets as they can further damage blood vessels. Then, the patient should be quickly transported to the hospital because delaying treatment can lead to permanent tissue damage, making successful finger reattachment impossible.

Doctors consider finger reattachment surgery for patients who have suffered the following injuries:

• Complete loss of the thumb.
• Loss of multiple fingers.
• Finger loss in children.
• Finger loss at the fingertip or near the middle joint.

However, if the patient has the following conditions, doctors may consider alternative surgical approaches:

• Severe tissue damage in the missing finger(s), making successful reattachment unlikely.
• Multiple segments missing from the same finger.
• Underlying medical conditions or additional injuries that make surgery risky or prolonged.
• Poor blood vessel condition.
• Psychological conditions that prevent compliance with postoperative care.
• Patients are brought to the hospital too late, the tissues of the finger may have died due to insufficient blood supply. In such cases, it may not be possible to successfully reattach the finger.

During the replantation surgery, the patient is under general anesthesia, so they do not feel anything. The bone is trimmed to allow for easier stitching without excessive tension. Then, tendons, veins, and arteries are stitched in sequence using a microscope.

After the surgery, the patient needs to stay in the hospital for 5-7 days for observation, wound care, and to ensure proper blood circulation to the reattached finger. If there are signs of reduced blood flow or complications, additional surgery may be necessary.

During the hospital stay, patients should avoid activities that could decrease blood flow to the finger, such as drinking tea, coffee, smoking, or being in cold environments. Once the finger shows signs of good blood circulation and the wound begins to heal, patients can be discharged with follow-up appointments for further evaluation and rehabilitation to regain finger movement.