Embedded Files
introduction
introduction
- May be associated with an avulsion injury. (1)
- Important to note mechanism of injury
- Avulsion (2)
- Commonly occurs as a result of a sudden pull on a finger ring resulting in severe soft tissue injury
- Laceration
- Crush
- Avulsion (2)
- Important to note mechanism of injury
- Partial (3)
- May need revascularisation
- Total
- Discuss with senior to decide whether replantable
- If replantation is opted for, it must be achieved within:
- 24 hours for a digit
- 4 hours for any part with a muscle involved
assessment
assessment
- Exact mechanism, timing and extent of injury must be detailed to determine whether the part is replantable. (4)
- Time of warm and cold ischaemia
- Advice to the referring centre:
- ‘Place the amputated part in well wrung out saline dampened gauze. Then put this in a sealable plastic bag. Place bag in a bowl of water/ice. The part must not directly contact with ice.’
- Amputate must not be placed in direct contact with water and ice!
management (5,6,7)
management (5,6,7)
Flowchart created using BSSH Guidelines on Amputation Injury Management
references
references
1. Chiu TW. Stone’s Plastic Surgery Facts: A Revision Guide, Fourth Edition. CRC Press; 2018. 2. Vannabouathong C, Ayeni OR, Bhandari M. A Narrative Review on Avulsion Fractures of the Upper and Lower Limbs. Clin Med Insights Arthritis Musculoskelet Disord. 2018;11:1179544118809050. 3. Sindhu K, DeFroda SF, Harris AP, Gil JA. Management of partial fingertip amputation in adults: Operative and non operative treatment. Injury. 2017 Dec;48(12):2643–9. 4. Green DP, Wolfe SW. Green’s operative hand surgery. Elsevier/Churchill Livingstone; 2011. 5. Pencle FJ, Waseem M. Fingertip Injuries. StatPearls. StatPearls Publishing; 2020. 6. Zhang L, Buckley CJ. Digit Amputation. StatPearls. StatPearls Publishing; 2020. 7. The British Society of Surgery for the Hand. Hand Injury Triage App [Internet]. [cited 2020 Feb 2]. Available from: handinjurytriageapp.bssh.ac.uk
Header Image: Licensed with Adobe Stock 2019
Header Image: Licensed with Adobe Stock 2019
This subpage has been reviewed by:
1) Mr. Martin Shapev - Plastic Surgery Registrar, RD&E (06/02/2020)
1) Mr. Martin Shapev - Plastic Surgery Registrar, RD&E (06/02/2020)
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