How to store an amputated part, what not to do, and the realistic window for replantation.
An amputated finger or hand can often be reattached, but only if the part reaches a microsurgical team in usable condition and in time. For a finger the realistic window is about six hours; for a hand or forearm it is shorter, because muscle tolerates loss of blood supply poorly. What happens in the first hour, at the roadside, in the workshop, at the local clinic, decides more than anything a surgeon does later.
Wrap the amputated part in clean gauze or a clean cloth. Place it inside a sealed plastic bag, and put that bag on ice or into cold water. The part must stay cool but must never touch ice directly, and it must never be washed, scrubbed or soaked in any liquid, including antiseptic. Direct ice contact freezes the tissue, and soaking waterlogs the vessels a surgeon needs to join. Both mistakes can turn a replantable finger into an unreplantable one.
Bleeding from a finger or hand stump almost always stops with firm pressure. Press a clean, folded cloth on the stump and keep the hand raised above heart level. Do not apply a tight tourniquet, wire or cord unless bleeding truly cannot be controlled with pressure, because a tourniquet left on during a long journey damages the remaining limb. Keep the injured person warm, calm and lying down if they feel faint.
Replantation happens under anaesthesia, and an empty stomach makes anaesthesia safer and faster to start. Keeping the patient nil by mouth from the moment of injury can save an hour at the hospital end of the journey.
Phone ahead to a centre with microsurgery cover and describe the injury, the time it happened and how the part is stored. A team that knows you are coming can ready the theatre, call in staff and start preparations, so surgery begins soon after arrival instead of an hour later. In South Gujarat, the emergency line on this site connects directly to the surgical team, and transfers are coordinated with referring hospitals routinely.
The part and the stump are examined and X rayed, blood tests and consent are completed, and the operation begins: bone is fixed first, then tendons, then the artery, veins and nerves are repaired under the operating microscope. Surgery commonly takes several hours for a single digit, and the first week after surgery involves close monitoring of the replanted part.
Not every part can be reattached, and an honest team says so early. The stump is then repaired to give the best possible grip, padding and comfort, and reconstruction options, including toe to thumb transfer for a lost thumb, can be discussed once healing is complete. Going to hospital is never wasted, whatever the clock says.
No. Washing or soaking damages the tissue a surgeon needs intact. Wrap it in clean gauze, seal it in a bag and keep the bag on ice, never the part directly on ice.
Yes, always go. The six hour window is a guide for replantation of a finger, not a rule, and even when reattachment is not possible the stump needs proper repair for future function.
Not necessarily. Correct cool storage buys time, and calling ahead lets the team prepare theatre while you travel, which saves more time than speed alone.
Wrap it in clean moist gauze, place it in a sealed bag, and put that bag on ice. The part must not sit directly on ice or in water, because freezing damages the tissue and rules out reattachment.
Apply firm pressure with a clean cloth and raise the limb, then keep the pressure on during travel. Avoid tying anything tightly around the limb unless bleeding cannot be controlled any other way.
The time of injury, how it happened, whether the part was crushed or cut cleanly, the person's age, other injuries, existing illnesses and medicines all matter. Calling ahead with these details lets theatre be prepared before you arrive.
Sometimes, but a crushing or avulsion injury damages vessels along a longer length and reduces the chance of success compared with a clean cut. It is still worth bringing the part, since the decision is made on examination.
