TechniqueDigital Replantation Including Postoperative CareAllen, Diane M. M.D.; Levin, L. Scott M.D.Author Information Division of Orthopaedics, Duke University Medical Center, Durham, North Carolina, U.S.A. Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, North Carolina, U.S.A. Address correspondence and reprint requests to Diane M. Allen, M.D., Assistant Professor, Division of Orthopaedics, Duke University Medical Center, Box 3384, DUMC, Durham, NC 27710; e-mail: [email protected] Techniques in Hand and Upper Extremity Surgery: December 2002 - Volume 6 - Issue 4 - p 171-177 Buy Abstract Digital replantation first became a reality in the 1960s with the advent of microsurgical techniques. Indications for replantation have evolved over the ensuing years and currently include 1) thumb amputations, 2) multiple digit amputations, and 3) amputations in children. Crush and avulsion injuries and amputations of a single digit proximal to the flexor digitorum superficialis insertion remain relative contraindications. Good communication between the replantation center microsurgeon and the referring physician is paramount to achieving appropriate and timely referrals and correct transport of amputated parts. Communication with patients is also important: possible candidates for replantation must be informed of the likely outcomes of replantation and revision amputation procedures, and the different postoperative regimens for each. For patients who choose revision amputation or whose replants do not survive, there are a variety of reconstructive options available, if necessary, such as toe-to-hand transfer. The techniques to perform such elective free tissue transfers have been perfected during the last 30 years largely from experience gained through digital replantation. © 2002 Lippincott Williams & Wilkins, Inc.