Hand and Upper Extremity Replantation

A surviving replant is only the beginning. The goal is a hand that can feel, move, and serve the patient’s needs.In this episode of Plastics in Practice, we review patient selection, preservation, injury assessment, reconstruction, monitoring, and rehabilitation after upper-extremity amputation.Key takeaways: • Useful function is the goal. Consider sensation, motion, pain, hand demands, and rehabilitation alongside the likelihood of survival. • Stabilize the patient and seek early specialist assessment. Preserve a detached part in saline-moistened gauze inside a sealed waterproof bag cooled in ice water; prevent direct tissue contact with ice or water. • Thumb loss, multiple-digit loss, and amputations in children merit careful replantation consideration. The final decision remains individualized. • Crush and avulsion can extend vessel injury beyond the visible wound. Debride to healthy tissue and plan a tension-free repair or an appropriate graft. • Arterial inflow and venous drainage are both necessary. A pale, cool digit with delayed refill or a swollen, blue digit with brisk refill needs urgent assessment by the replant team. • Protect the reconstruction while planning hand therapy. Survival, useful motion, sensory recovery, and return to activity are separate outcomes.This content is for educational purposes only and is not medical advice.The podcast audio is generated with Google NotebookLM using AI voices. The accompanying Short and explainer use recorded human narration and original AI-assisted teaching animations and anatomical illustrations. These visuals are educational reconstructions, not patient footage.🎧 Full episodes available now: Instagram: https://www.instagram.com/plasticsinpractice/ Spotify: https://open.spotify.com/show/4Ct8jOgYXP9QJin7QOuG3Z?si=JNcBxQmwT2mfz1LSJZEFKA Apple: https://podcasts.apple.com/us/podcast/plastics-in-practice-resident-review/id1835564216 YouTube: https://youtube.com/@plasticsinpractice?si=tqLInp5vvsJFKlRO Amazon: https://music.amazon.com/podcasts/8bef056e-7c87-4224-978e-7e691b04554a/ 📘 Free Study Guides: → https://drive.google.com/drive/u/0/folders/12BUldPbCmihG-ndZh6992WqhRYyxw8ZZ#Replantation #Microsurgery #HandTrauma #HandSurgery #UpperExtremity #PlasticSurgeryEducation #PlasticsInPracticeReferences: 1. American Society for Surgery of the Hand. Arm, Hand and Finger Replantation. https://assh.my.site.com/handcare/condition/hand-arm-finger-replantation 2. British Society for Surgery of the Hand and GIRFT. Amputations pathway. https://www.bssh.ac.uk/_userfiles/pages/files/professionals/girft/girft-amputations.pdf 3. American Academy of Orthopaedic Surgeons. Replantation. https://www.orthoinfo.org/treatment/replantation 4. Chung KC et al. Patient-Reported and Functional Outcomes After Revision Amputation and Replantation of Digit Amputations: The FRANCHISE Multicenter International Retrospective Cohort Study. JAMA Surg. 2019. doi:10.1001/jamasurg.2019.0418 5. Lee ZH et al. Survival after digit replantation and revascularization is not affected by the use of interpositional grafts during arterial repair. Plast Reconstr Surg. 2019. doi:10.1097/PRS.0000000000005343