Trauma due to roping injuries, table saws and power machinery, and many other types of accidents can cause amputation, near-amputation and limb-threatening injury. Some amputations can be re-attached, and many severely injured limbs can be saved.

The Denver Clinic for Extremities at Risk is recognized as the regional center for replants. Emergency health care professionals can call 1-800-262-LIMB 24 hours a day, and talk with a triage coordinator from The Denver Clinic staff.

The on-call replant surgeon will discuss the case with the referring physician and a decision is made regarding replantation. The Denver Clinic staff  schedules surgery, and assists the referring facility with coordinating transportation.

Replanting an amputated part is a tedious process that can take 8-12 hours, which must be performed in an operating room, under a microscope. The arteries, veins, and nerves which must be sewn together are small, the sutures cannot be seen with the naked eye.

How much function and sensation return to the replanted part may not be known for months or years. The patient typically must go through extensive rehabilitation after surgery to achieve the best possible outcome. This is a big commitment on the part of the patient and their family, and must be considered prior to performing the replant.

Overall, many patients have a good outcome after replantation and many return to their previous profession and/or hobbies. Although the replanted part will never be "normal" again, most patients are extremely satisfied with their results.

The "Do's and Don'ts" when handling an amputated part.
DO:
Wash the parts thoroughly in isotonic solution (preferably Ringer's Lactate)
Wrap amputated part in sterile gauze, moistened with solution of normal saline
Place part in a sterile container, e.g. a sterile unine analysis jar
Place this container into a secong container filled with crushed ice. DO NOT place the severed part directly on ice.

DON'T:
Do not freeze the part by placing it directly on ice or by adding any other coolant such as dry ice.
Do not float the part in a bag of solution
Do not use any antiseptic or other solutions on the part
Do not allow the tissue to dry
 

Cooling is essential to the success of replantation but DO NOT freeze the amputated part.