How do you store an amputated digit?
A right handed factory worker was injured with an circular saw which left him with an amputated index finger in what is called zone II or "no-mans land". There are many considerations when faced with amputations and replant surgery, and I would like to touch upon a few important points here :
When a limb part is amputated, storage of the amputated part is important. The part should ideally be placed in a plastic bag and then the plastic bag in another bag with ice so that the amputated part is kept cool. Direct contact with ice is not advised and nor is submerging the part in a fluid.
The discussion around replantation is complex and therefore requires a conversation with a trained hand surgeon who is able to offer you a replantation surgery. But just because it can be done does not always mean it should be done. For instance, in the above case, the man is a physical labourer, his employment is important not only for his livelihood but also for retention of his work visa in the country. Therefore a protracted time off work in rehabilitation, for an amputation injury that if salvaged and all goes well he will have approximately 40-50% of pre-injury function; did not for him seem a viable solution. Recovery would take anything from 3 to 12 months complication dependent.
Discussing the options a choice was made to close the amputation stump, understanding that the index finger is not necessarily indispensable for particular scenario.
The first image shows the amputated part of his index finger. The patient had multiple other injuries of the extensor tendons which were repaired (Image 2).
