Surgery Book

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Limb AmputationAka: Finger Amputation, Extremity Amputation

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  1. See Also
    1. Fingertip Amputation
  2. Indications for reattachment of hand, wrist or forearm
    1. Amputated limb or finger in children
    2. Multiple fingers involved
    3. Amputated thumb
    4. Clean amputation
  3. Risk factors for failed limb reattachment
    1. Amputation through proximal phalanx (esp. index, pinky)
    2. Tobacco Abuse
    3. Crushed or significantly contaminated wound
  4. Management: Amputated part care
    1. Assign staff to be responsible for amputated part
    2. Gently clean limb
      1. Remove external debris
      2. Irrigate wound surface with sterile isotonic saline
      3. Do not submerge amputated part in liquid
    3. Wrap part in nonadherent Vaseline Gauze
      1. Dampen gauze with sterile isotonic saline
    4. Place amputated limb in closed sterile container
    5. Place container in ice water
    6. Do not discard any tissue until surgeon consulted
  5. Management: Patient and wound site
    1. Consult replant surgeon
    2. ABC Management
    3. Hemostasis
      1. See Finger Wound Hemostasis
    4. Intraveous fluids
    5. Tetanus prophylaxis
    6. Irrigate wound site with sterile saline
    7. If amputated limb is still partially attached
      1. Avoid unnecessary manipulation
      2. Realign limb if rotated
      3. Splint in place
    8. Wrap wound in nonadherent Vaseline Gauze
    9. Apply dry compression bandage over Vaseline Gauze
  6. . Keep wound cool with insulated cold water packs
    1. Transfer to facility for possible limb reattachment
  7. References
    1. Antosia in Marx (2002) Rosens Emergency Med, p. 493-534
    2. Daniels (2004) Am Fam Physician 69:1949

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