Bertha Kawilarang
BACKGROUND Finger amputation is the separation of finger parts mostly due to trauma. It is a common case in emergency department particularly in the developing countries where various accidents occur at workplace. The finger makes up for the high functionality of the hand, and care of these cases is often complicated. Replantation is a surgical procedure to reattach amputated parts which aims to restore both the functionality and form of amputated limb. Its procedure involves a sequence of repair including bone fixation, repair of tendon, muscles, and microsurgical repair of the artery and veins. Health care providers in the emergency department must recognize amputation injuries in a timely manner so as to prepare for prompt replantation if indicated. There are different classification systems that can be used to describe the replantation injury. Thorough evaluation and diagnosis of finger amputations must be communicated well with the referring specialist, as many issues must be considered including level and type of injury, tissue viability with regard to ischemia time, as well as patient’s comorbidities. Indications of replantation can be absolute or relative, and must be discussed with both replantation team and the patient. Preservation of the amputated part is important as it is a key prognostic factor of replantation success. Patient must be educated well about the risks and benefits of replantation, as well as the need for rehabilitation strategy and close monitoring in the future to prevent long-term complications of the replanted finger.
