Before
Before surgery, you will undergo general anesthesia to ensure you are completely asleep and pain-free during the procedure. Following this, a thorough assessment will take place to remove damaged tissue, leaving only healthy tissue for reattachment. The surgical team will identify all repair sites, which will guide the procedure.
During
If necessary, bones will be meticulously cleaned, shortened (if needed), and then reattached using various methods such as wires, pins, plates, or screws.
One of the most technically demanding and crucial aspects of the procedure is the repair of blood vessels. Microsurgery techniques are employed to address vascular damage, as the proper restoration of blood flow is essential for the survival of the re-attachment. Additionally, your surgical team will repair or reattach tendons, nerves, and muscles to ensure that the limb or digit can regain mobility, sensation, and strength.
Following the repair of all internal structures, the skin is carefully closed, and the reattached limb or digit is placed in a splint or cast. Soft tissue reconstruction may be necessary in the form of skin or muscle transfer in addition to skin grafting or skin replacement.
Completion Amputation
In situations where reattachment is not a viable option, an alternative known as completion amputation may be considered. This involves the cleaning, smoothing, and covering of the cut end. In some cases, this approach can lead to a quicker and more successful recovery than attempting reattachment. Furthermore, there are scenarios where the body's natural regenerative capacity can be harnessed to facilitate the regrowth of lost tissue, providing another avenue for recovery and rehabilitation.
After
After the surgery, you will be closely monitored in the recovery area to ensure your well-being and survival of the reattached limb. Depending on the extent of the procedure and your overall condition, you may or may not require a hospital stay, which will be determined by your healthcare team. You might experience some discomfort, which can be managed with pain medication. Swelling and limited mobility in the treated area are common and should improve gradually. Our medical team will provide clear post-operative care instructions, including wound care, physical therapy, and any necessary follow-up appointments to support your recovery and ensure the best possible outcome.
Recovery
The reattachment of a severed body part is not only technically demanding on the surgeon, but it is also very demanding on the patient. Our specialists believe that the successful outcome of any reattachment is 50% related to how well it is surgically repaired, and 50% how well the patient completes the recovery process, including therapy.
Patients must be committed to multiple months of being unable to use the reattached part and multiple months of therapy. Physical therapy and the use of splints are essential to the recovery process. From the beginning, splints are used to protect the newly repaired tendons. Hand therapy is eventually used to keep the joints from getting stiff and to prevent the tendons from getting stuck.
We ask patients to understand that there must be a balance between letting the reattached body part rest and recover against the likelihood for tendons and joints to get stuck in place due to the necessary period of immobilization. Most patients will require at least one or two further surgeries to remove scar tissue in an attempt to improve the motion of the reattached body part.
