Modern surgical techniques allow reattachment of severed digits in many circumstances. A patient with one or more indications and no contraindications for reattachment should be referred to a center specializing in this form of surgery.
Indications:
(1) clean guillotine-type amputation
(2) amputation through the middle phalanx of the digit
(3) amputations of multiple digits
(4) amputation of the thumb
Contraindications:
(1) crush injury
(2) avulsion injury
(3) heavy contamination with bacteria, environmental debris or chemicals
(4) multiple level amputations of the same extremity
(5) improperly preserved digit
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