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Semin Plast Surg 2013; 27(04): 182-189
DOI: 10.1055/s-0033-1360585
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Challenges in Replantation of Complex Amputations

Harvey Chim
1   Department of Plastic Surgery, Case Western Reserve University, Cleveland, Ohio
,
Marco A. Maricevich
2   Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota
,
Brian T. Carlsen
2   Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota
,
Steven L. Moran
2   Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota
,
Christopher J. Salgado
3   Division of Plastic Surgery, University of Miami, Coral Gables, Florida
,
Fu-Chan Wei
4   Department of Plastic Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan
,
Samir Mardini
2   Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota
› Author Affiliations
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Publication History

Publication Date:
27 November 2013 (online)

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Abstract

Surgical ingenuity has resulted in continuing microsurgical innovation in replantation. In this article, the authors define complex amputations as those that stretch the boundaries or fall outside traditionally defined indications for replantation. They discuss management of difficult situations involving multiple digit amputations, multiple-level amputations, prolonged ischemia, and multiple trauma. The role of transpositional and ectopic replantation, as well as the requirement for secondary procedures in replantation is also discussed. Although technically challenging, microsurgical management of complex amputations ultimately results in far superior outcomes.

Keywords

replantation - amputation - microsurgery - multiple trauma - rehabilitation - transpositional replantation - multiple digit replantation - multiple level amputation - ischemia
 

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