Reattachment

Replantation
Intervention
ICD-10-PCS	0?M
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Replantation has been defined by the American Society for Surgery of the Hand as "the surgical reattachment of a body part, most commonly a finger, hand or arm, that has been completely cut from a person's body".

Replantation of amputated parts has been performed on fingers, hands, forearms, arms, toes, feet, legs, ears, avulsed scalp injuries, a face, lips, penis and a tongue.

The repair of the nerves and vessels (artery and vein) of the amputated part is essential for survival and function of the replanted part of the body. Using an operating microscope for replantatation is termed microvascular replantation. However, vessels and nerves of large amputated parts (e.g. arm and forearm) may be reconnected using loupe or no magnification.

The first replantation to be performed in the world involved repair of the brachial artery and was done by a team of chief residents led by Dr. Ronald Malt at Massachusetts General Hospital in Boston, Massachusetts, United States in 1962. The arm of a 12-year-old child severed at the level of the proximal humerus was reattached.

The first report of a replantation using "modest magnification and keen vision" was reported by a team led by Zhong-Wei Chen of the Sixth People's Hospital in Shanghai in 1963 writing in the Chinese Medical Journal. A machinist's hand was reattached at the level of the distal forearm. In this case vascular couplers were used for the vessels as the Chinese did not have good micro sutures available at that time. As there was little communication between China and the Western World in those years, Ronald Malt and Charles McKhann published in JAMA in 1964 their first two replantations without referencing the earlier published article from China.

First revascularization of a partially amputated finger: Kleinert (1963) First digital replantation: Komatsu & Tamai, Japan (1965)

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