Podcast 798: Digit Reimplantation

Contributor: Aaron Lessen, MD Educational Pearls: Multiple factors affect if a digit can be reattached including: location of digit injury, mechanism of injury, duration since injury, preservation mechanism.  Recommended preservation is via indirect cooling. This is accomplished by wrapping the amputated digit piece in saline soaked gauze, placing the wrapped piece in a waterproof bag and putting the bag in ice water for transport. Avoid direct contact of the digit with ice.  A single center study showed that only 34% of the total digits received were properly preserved. Lower rates of indirect cooling were seen in patients arriving from home or via EMS (25% and 35% respectively). Of those transported from referring hospitals, still only 45% of digits were properly preserved. Therefore, consider providing preservation instructions for indirect cooling to those transporting amputated digits.    References Zhang L, Azmat CE, Buckley CJ. Digit Amputation. In: StatPearls. Treasure Island (FL): StatPearls Publishing; April 30, 2022. Massand S, Sinatro H, Liu AT, Shen C, Ingraham JM. Improper Preservation of Amputated Parts: A Pervasive Problem. Plast Reconstr Surg Glob Open. 2020;8(9 Suppl):100-101. Published 2020 Oct 9. doi:10.1097/01.GOX.0000720828.15941.c5    Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD   The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account.  Donate to EMM today!