Indications for hand replantation need to take into account the patients general condition and the severity of the trauma. The advanced age of the patient is generally considered as a limiting factor of the replantation but does not absolutely disqualify a patient.
The case of a right - handed man, 83 years of age is presented, who had a circular- saw wrist level amputation of his dominant hand. As the general condition of the patient was satisfactory, the wound was clean, and the ischemia time was only 3 hrs the replantation of the hand was decided. The procedure was performed in a standardized way, the revascularization took place 7 hrs after injury. In the early post-operative period within the replanted part skin and soft tissue necrosis developed. It was treated with hyperbaric oxygen therapy, pediculed skin flap, and after its failure omental flap. The early functional result was poor (Chen's IV°). Patient died 27 weeks after replantation due to complications of coronaroplasty. The problems involved in replantation of hands of senile patients are discussed.
Financed by the National Centre for Research and Development under grant No. SP/I/1/77065/10 by the strategic scientific research and experimental development program:
SYNAT - “Interdisciplinary System for Interactive Scientific and Scientific-Technical Information”.