Managing vascular compromise of hand and digit replantation following traumatic amputation

Hands are anatomically complex and have great social, physical and emotional importance. Hand or digit replantation following traumatic partial or complete amputation is a complex injury for nursing staff to understand and manage. The absence of clear guidance, combined with a lack of consensus in the literature gives rise to ambiguity and insufficient understanding of appropriate and effective management. This article aims to outline nursing care of the patient in the first few days following hand or digit reattachment, particularly focusing on the recognition and management of arterial and venous compromise. Complications must be recognised and acted on quickly to give the best chance of survival so it is essential for nurses to have an accurate understanding of the signs, symptoms and management options of vascular compromise. Leech therapy, also discussed, has long been used as a nonsurgical option in the management of venous congestion and is a simple and minimally invasive method of managing congestion.