Replantation

Abstract

In the 1970s, when the possibilities for replantation were relatively unexplored, this procedure was thought to be appropriate only for clean-cut, “guillotine-type” amputations. Within 5–10 years, however, many adventurous attempts accomplished the salvage of avulsed or mangled parts. More cautious surgeons objected, citing poor ultimate function following such injuries. Uncertainty and controversy abounded, and the distinction between the kind of injuries that should be replanted and those that should be amputated was unclear. Eventually, many replantation centers generated reports of large series of patients, and these reports began to clarify the indications for replantation (Chow et al. 1979, May et al. 1982, O’Brien et al. 1974, Tamai 1982, Urbaniak et al. 1985, Weiland et al. 1977). While these indications continue to evolve and do depend partly on the experience, skill, and opinion of the surgeon, each injury can be analyzed with regard to some basic prognostic features.