REPLANTATION OF MULTILEVEL HAND SEVERANCES

Since 1990, the replantation of hands severed at multiple levels has b een carried out successfully for 22 patients. In each case the motor a nd sensory functions of the hand were recovered satisfactorily. We sug gest that such wounds should be named 'multilevel severances and shoul d be classified into five groups according to the wound localities. In order to shorten ischaemic time, debridement should be carried out si multaneously by several groups. The main technical points of the opera tion Rue: (1) The order of replantation for multiply severed fingers i s that the most distant section should be reattached first, and then t he more proximal part. (2) High quality blood vessel anastomosis must be ensured. (3) Avoid taking the blood vessels, nerves and tendons fro m severed region. (4) During the operation, care should be taken to en sure that the replanted fingers' segments are protected front collisio n and stretching. In the early stages following the operation correct functional exercise is very important. (C) 1998 Elsevier Science Ltd. All rights reserved.