All amputation cases are acute emergencies and it is necessary to be able to perform operations around the clock. In addition, it is necessary to be able to perform immediate revisionary surgery following thromboses. Such demands can only be met by an organised replantation service which is always available. Furthermore, an operating theatre with its personnel must be available and in immediate readiness. The replantation surgeon, in addition to being trained in microsurgery and hand surgery, should have at his command the basic concepts of plastic surgery and traumatology. The successful replantation service is confined to a large unit since, to teach and train microsurgery, close collaboration is essential with the experimental surgery department, and postoperative monitoring and management require trained ward personnel, physiotherapists and occupational therapists.