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Extremity Tumors
Bone Healing Program
Non-union of Fracture
Bone Infection
Leg Deformities
Osteonecrosis
Amputation Reconstruction
Amputations
Mangled Extremity Program
Replantation
Replantation of Traumatic Amputations

Trauma due to roping injuries, table saws and power machinery, and many other types of accidents can cause amputation, near-amputation and limb-threatening injury. Some amputations can be re-attached, and many severely injured limbs can be saved.

thumb_initial_injury.jpg  thumb_residual_thumb.jpg   thumb_thumb_replant_post.jpg
 Table saw amputation
 of thumb		  Residual thumb prior to
 reattaching		    Thumb immediately
   after reattaching

The Denver Clinic for Extremities at Risk is recognized as the regional center for replantation of severed extremities. Emergency health care professionals can call 1-800-262-LIMB(5462), 24 hours a day and speak with a triage coordinator from the Extremities at Risk staff.

About Our Program
  • Expert management of single system upper extremity trauma
  • Plastic surgeons with fellowship training in microvascular and hand surgery 
  • Team of plastic surgeons, orthopedic surgeons, and vascular surgeons for extensive upper extremity trauma 
  • Coordination of patient transport from referring facility to Presbyterian/St. Luke's Medical Center
  • Replant surgeons will provide phone consultation to referring physician and the patient for managmeent decisions prior to transport 
  • Certified hand therapist for immediate post-operative care

Patients Managed by Fellowship Trained Microvascular Surgeons

Replanting an amputated part is a tedious process that can take 8-12 hours, which must be performed in an operating room, under a microscope. The arteries, veins, and nerves which must be sewn together are small, the sutures cannot be seen with the naked eye.

How much function and sensation return to the replanted part may not be known for months or years. The patient typically must go through extensive rehabilitation after surgery to achieve the best possible outcome. This is a big commitment on the part of the patient and their family, and must be considered prior to performing the replant.

Overall, many patients have a good outcome after replantation and many return to their previous profession and/or hobbies. Although the replanted part will never be "normal" again, most patients are extremely satisfied with their results.


The "Do's and Don'ts" when handling an amputated part.
DO:
Wash the parts thoroughly in isotonic solution (preferably Ringer's Lactate)
Wrap amputated part in sterile gauze, moistened with solution of normal saline
Place part in a sterile container, e.g. a sterile unine analysis jar
Place this container into a secong container filled with crushed ice. DO NOT place the severed part directly on ice.

DON'T:
Do not freeze the part by placing it directly on ice or by adding any other coolant such as dry ice.
Do not float the part in a bag of solution
Do not use any antiseptic or other solutions on the part
Do not allow the tissue to dry
 

Cooling is essential to the success of replantation but DO NOT freeze the amputated part.

Last Updated ( Friday, 26 June 2009 )