Three-Year (2017-2019) Activity Report Of The Replantation Service For Amputated Hands In Poland

This article summarizes the activity of the Replantation Service for hand amputations in Poland in years 2017-2019. Over this period, a total of 551 cases of total and subtotal amputations as well as other complex injuries to the hand were referred to the referenced centers. Of these, 330 referrals were accepted and 221 rejected, for various reasons. Among these accepted, there were 165 total (50%) and 131 subtotal (40%) amputations; 34 patients (10%) had other severe hand injuries. The vast majority of the patients constituted young and middle-age males. The most common was amputation of several digits and thumbs-a total of 251 cases (76%), followed by transmetacarpal -30 (9%), forearm-23 (7%) and wrist -20 (6%) amputations. Replantation of the amputated extrem ity was performed in 138 patients (42%), revascularization in 98 (30%) and in 45 (14%) primary repair of complex injuries. In 26 cases (8%), coverage of tissue defects was performed, and in 23 (7%) primary terminalization. The survival rate was on average 65% for replantations and 85% for revascularizations. Comparing to the previously reported period 2013-2017, the number of treated patients was similar, but the structure of injuries differed: the number of digital amputations increased (by 22 cases), whereas the number of proximal amputations (hand, forearm and arm) dropped significantly (by 50 cases). The importance of the Replantation Service, an informal structure, in saving limbs of severely mutilated patients was emphasized.