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Amputation Traumatic/Replantation, Emergency Medicine

Charlotte A. Sadler Reviewed 06/2017
 


Basics

Description

  • Partial amputations have tissue connecting the distal and proximal parts and are treated by revascularization.

  • Complete amputations have no connecting tissue and may be treated by rep...

Diagnosis

Signs and Symptoms

History

  • Exact time of injury is critical, as ischemia time predicts success for replantation:

    • Irreversible muscle necrosis begins at 6 hr of ischemia.

    • The temperature and amou...

Treatment

Pre-Hospital

  • Collect all amputated body parts, including pieces of bone, tissue, and skin.

  • See “Initial Stabilization” for care of amputated parts during transport.

  • Transport patient and body p...

Follow-Up

Disposition

Admission Criteria

Hospitalization is required for all patients undergoing replantation or revascularization. 

Discharge Criteria

  • Mild fingertip amputations or mild degloving injurie...

Pearls and Pitfalls

  • Every effort should be made to minimize ischemia time

  • Expeditious consultation or transfer to appropriate surgeon and team is paramount.

  • Avoid any direct contact of the amputated par...

Additional Reading

  • Davis  S, Chung  KC. Replantation of finger avulsion injuries: a systematic review of survival and functional outcomes. J Hand Surg.  2011;36(4):686–694.

  • Lloyd  MS, Teo  TC, Pic...

Codes

ICD9

  • 885.0 Traumatic amputation of thumb (complete)(partial), without mention of complication

  • 886.0 Traumatic amputation of other finger(s) (complete) (partial), without mention of complication

  • 887...

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