Hand Injury and Digit Reimplantation

Abstract

Hand trauma can have devastating long-term consequences on a patient’s quality of life as well as their ability to care for themselves and their family. This is especially true when upper extremity trauma is combined with digit amputation. Although acute operative management will minimize the tissue’s ischemic time, anesthetic management may also impact graft survival. Perineural brachial plexus catheters may also improve patient outcomes through sympathetic blockade, resulting in vasodilation and improved graft perfusion. Regional anesthesia may provide further benefits by reducing the risk of chronic postsurgical pain. Conversely, compartment syndrome is a significant risk for patients with forearm trauma. While regional anesthesia techniques have not been shown to mask compartment syndrome, vigilance by all medical team members and constant communication are essential for early detection to decrease morbidity and mortality.