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CC BY-NC-ND 4.0 · Indian J Plast Surg 2023; 56(03): 273-275
DOI: 10.1055/s-0043-1768916
Case Report

Replantation of an Amputated Hand at Wrist Level Due to Self-Mutilation: Considerations in Management

Ashwini Vardharajan 
1   Department of Plastic, Hand, and Microsurgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, Tamil Nadu, India
,
Monusha Mohan
2   Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, India
,
Dakshana Pushpanathan
3   Department of Psychiatry, KMCH Institute of health Sciences and Research, Coimbatore, Tamil Nadu, India
,
Hari Venkatramani
2   Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, India
,
S. Raja Sabapathy
2   Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, India
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Abstract

Major self-mutilations include injury to limbs, eyes, or genitals due to various psychiatric illnesses. Limb amputations are grievous injuries that radically decrease the quality of life. Controversy exists as to the advisability of replantation of the self-amputated limb. We report a case of self-amputation of the hand in a 54-year-old gentleman in a fit of psychosis. He underwent replantation of the hand and was given timely psychiatric help. Interdisciplinary management helped in improving the mood of the patient and he cooperated well with the rehabilitation schedule. Recent literature encourages surgeons to replant the limb and treat the mental illness with close observation for warning signs. We conclude that replantation along with early initiation of psychiatry treatment can help the patient overcome psychosis, realize the implications of his actions, and provide the motivation to perform physiotherapy to achieve the optimum outcome possible in the replanted hand.

Keywords

major self-mutilation - replantation - psychiatry

Authors' Contributions

All authors were involved in the clinical care of this patient, the design and conception of this paper, and the writing and revising process.


Ethics Approval Statement

This study was exempt from institutional board review per our institutional policy on small case reports. Our study was performed in accordance with and conforming to the Declaration of Helsinki.




Publikationsverlauf

Artikel online veröffentlicht:
02. Mai 2023

© 2023. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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