Postoperative Management and Rehabilitation in Limb/Digit Replantation

Abstract

Postoperative management starts in the operating room after the replantation surgery has been completed. Dressing of the hand and arm is important to keep the functional position of the replanted digits and hand and to keep the wound clean by letting the gauze soak up the discharge from the wound. The intrinsic plus position of the fingers, palmar abduction of the thumb, and neutral position of the wrist are the basic functional positions of the hand, even though both flexor and extensor tendons are repaired. The first interdigital space should be kept open by packing enough gauze to prevent adduction contracture of the thumb. Thin gauze is sandwiched between the fingers without compressing the replanted fingers. Thick gauze is then applied to the dorsal and palmar aspects of the hand and forearm.