Podcast 798: Digit Reimplantation - The Emergency Medical Minute

Podcast 798: Digit Reimplantation

Contributor: Aaron Lessen, MD

Educational Pearls:

  • Multiple factors affect if a digit can be reattached including: location of digit injury, mechanism of injury, duration since injury, preservation mechanism. 
  • Recommended preservation is via indirect cooling. This is accomplished by wrapping the amputated digit piece in saline soaked gauze, placing the wrapped piece in a waterproof bag and putting the bag in ice water for transport. Avoid direct contact of the digit with ice. 
  • A single center study showed that only 34% of the total digits received were properly preserved. Lower rates of indirect cooling were seen in patients arriving from home or via EMS (25% and 35% respectively). Of those transported from referring hospitals, still only 45% of digits were properly preserved. Therefore, consider providing preservation instructions for indirect cooling to those transporting amputated digits.   

References

Zhang L, Azmat CE, Buckley CJ. Digit Amputation. In: StatPearls. Treasure Island (FL): StatPearls Publishing; April 30, 2022.

Massand S, Sinatro H, Liu AT, Shen C, Ingraham JM. Improper Preservation of Amputated Parts: A Pervasive Problem. Plast Reconstr Surg Glob Open. 2020;8(9 Suppl):100-101. Published 2020 Oct 9. doi:10.1097/01.GOX.0000720828.15941.c5 

 

Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD

 

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