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Replantations surgery following self-inflicted amputation

D E Stewart, M R Lowrey

    Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
    |March 1, 1980
    PubMed
    Summary
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    This study reviews four cases of self-inflicted upper limb amputation and surgical replantation. Most patients achieved good functional and psychological outcomes, highlighting the potential for successful limb replantation in select self-mutilation cases.

    Area of Science:

    • Reconstructive Surgery
    • Psychiatry
    • Trauma Surgery

    Background:

    • Self-inflicted amputations, while rare, present unique challenges in surgical replantation.
    • Understanding the psychological underpinnings of self-mutilation is crucial for patient selection and management.

    Observation:

    • Four cases of self-inflicted upper limb amputation with subsequent surgical replantation were analyzed.
    • Three patients demonstrated positive outcomes, including psychiatric stability, employment, and satisfaction with the surgical result.
    • One patient tragically died by suicide, underscoring the complex psychological factors involved.

    Findings:

    • Successful surgical replantation is possible in carefully selected cases of self-inflicted amputation.
    • Psychiatric well-being significantly influences the long-term success and patient satisfaction following limb replantation.

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  • The review of existing literature emphasizes the need for a multidisciplinary approach involving surgeons and psychiatrists.

    • Implications:

    • These findings suggest that a thorough psychiatric evaluation is essential prior to considering limb replantation in cases of self-mutilation.
    • The role of the psychiatrist is critical in assessing risk, managing underlying psychological conditions, and supporting patients throughout the treatment process.
    • Further research is warranted to establish clear guidelines for managing patients with self-inflicted amputations requiring replantation surgery.