Replantation of Amputated Segments after Prolonged Ischemia

Abstract

We present the results obtained with 15 replanted segments that underwent prolonged ischemia. Eight digits and one hand suffered 18 to 24 hours of warm ischemia and another six fingers had 30 to 74 hours of cold ischemia. Replanted segments that survived had undergone 18, 19, 19, 21, 22, 24, and 24 hours of warm ischemia or 32, 32, and 48 hours of cold ischemia. Functional results, according to Nakamura and Tamai's classification, were considered excellent in three patients, good in four patients, and fair in three. Five replants failed. Functional results show no correlation with duration of ischemia or age. We believe that amputated parts with 24 hours of warm ischemia or 48 hours of cold ischemia are subjects for replantation, with the chance of a similar rate of functional success as replantations undertaken within classically accepted periods of ischemia.