What is replantation?
Replantation is a surgical procedure where a detached body part, such as a finger, hand, or arm, is reattached to the body. The goal of the procedure is to restore the lost part to its previous function as much as possible. If the injured area has suffered severe damage, replantation may not be possible. In such cases, a person can use prosthetic devices to partially regain their lost functions.
Replantation procedure consists of several stages. First of all, the damaged area is thoroughly cleaned, the exposed bone ends are trimmed, and the arteries, veins, nerves, muscles, and tendons are sutured back into place. Skin grafts (the name given to the transplanted tissue) are used to cover any skin losses from healthy areas of the body.
During the healing process, the most important role falls on the patient. Smoking reduces blood flow to the replanted area and greatly reduces the tissue’s ability to survive. Carrying the replanted area above heart level also causes the same effect. Young patients are luckier in terms of nerve repair development, which gives them an advantage in feeling and movement of the replanted area. The lower the injury site is in the arm, the greater the ability to move after replantation. Injuries without joints heal faster.
Clean injuries provide better results than work accidents or crush-type injuries. In healing, the recovery of two types of nerves plays an important role. One is sensory nerves responsible for the sense of touch, and the other is motor nerves responsible for movement. Nerve healing can be considered to be 2.5 cm per month. The minimum time required for nerve healing can be calculated by considering the distance from the patient’s injured area to the tip of their finger. The replanted area will never be the same as before. 60-80% return of function is considered an excellent result. Even in the most perfect results, cold weather can cause serious problems.
Postoperative care and rehabilitation can take a very long time. Physical therapy and splinting constitute the first stage. Splints protect repaired tendons and are crucial in learning how to move the replanted area. Rehabilitation helps to reduce stiffness and scar tissue in the repaired area. Even in cases where treatment is successful, patients may not be able to perform certain tasks. Some patients can use devices specially designed for them to enjoy their favorite hobbies. Only a portion of patients can return to their jobs before the injury, and many need to change their careers.
There may be some psychological problems in the person after replantation. When the bandage is first opened and the person sees the wound, they may become angry, upset, or very surprised because the replanted area does not look the same as before. Over time, appearance-related concerns give way to functional concerns. In such cases, patients need to be enrolled in psychological support programs.
Sometimes, additional surgeries may be needed to improve the functional condition of the replanted area when there is no concern about its vitality.