Hand/Finger Reimplantation

Patients Requiring Hand/Finger Reimplantation

Decision to transfer/divert a patient needing revascularization/replantation will be made based upon:

· Patients with isolated, or near isolated, amputation or devascularization injuries should be transferred to nearest hand reimplantation center.

· Recovery of devascularized or amputated parts with mechanism of injury reasonable for replantation

· Determination of warm/cold limb ischemia time and ability to transport to appropriate replantation center prior to exceeding replantation time limits

o Digit

§ Warm Ischemia <12hrs

§ Cold Ischemia <24hrs

o Hand/Limb

§ Warm Ischemia <6hrs

§ Cold Ischemia <12hrs

· If patient is unable to reach a replant center prior to the ischemia limit, transfer to nearest regional trauma center for additional care.

***Important to note: Patients with multiple traumatic injuries, including hand/arm amputation/devascularization, may not be appropriate for transfer to nearest reimplantation center due to concomitant injuries. In these situations, it may be “life over limb” so transport to the nearest trauma center should take precedent.***

Never hesitate to contact your regional trauma center for guidance on patient transport appropriateness.

Regional Hand Reimplantation Centers:

Adults and Pediatrics

· Nebraska Medicine- consider for potential replantation/revascularization:

402-559-BEDS (9337)

· Denver Health Trauma:

1-855-602-5280 OR 303-628-1550

· University of Iowa

1-866-890-5969

· St. Louis (Barnes-Jewish: Adults/St. Louis Children’s: Pediatrics)

800-678-HELP (4357)

· Regions Hospital- St. Paul, MN:

888-588-9855

· Mayo Clinic

507-255-2910

Adults Only:

· Faith Regional Hospital in Norfolk- Dr. Hartzell

402-371-4880

· KU- Kansas City

913-588-1227

· University of Missouri

573-882-4141

Pediatric Only:

· Children’s Mercy Kansas City, MO

1-800-GO-MERCY

1-800-46-63729