Salvage of Amputated Upper Extremities with Temporary Ectopic Implantation Followed by Replantation at a Second Stage

ABSTRACT

Salvage of the complex amputation of extremities, such as combined with devastating segmental injuries, extensive soft tissue defect, and multiple important organ injuries, continues to be a challenge for plastic surgeons. Temporary ectopic implantation of the amputated part to a healthy recipient site allows the patient to recover from critical combined injuries, radical debridements, and soft tissue repair. In this article, the authors report two cases of temporary ectopic implantation of complexly amputated forearms, followed by successful replantation to their anatomic positions at a second stage. The contralateral upper extremity is an acceptable recipient site for temporary ectopic implantation. In secondary replantation, a cross-arm flap can be designed to carry the vascular pedicle from the ectopic implantation recipient to improve blood supply to the replanted part when the second blood supply is established. The authors validated that temporary ectopic implantation of amputated parts provides an alternative procedure for the salvage of amputated extremities under special circumstances.

KEYWORDS

Replantation - ectopic implantation - extremity - amputation

REFERENCES

• 1 Godina M, Bajec J, Baraga A. Salvage of the mutilated upper extremity with temporary ectopic implantation of the undamaged part.  Plast Reconstr Surg. 1986;  78 295-299
• 2 Chernofsky M A, Sauer P F. Temporary ectopic implantation.  J Hand Surg Am. 1990;  15 910-914
• 3 Matloub H S, Yousif N J, Sanger J R. Temporary ectopic implantation of an amputated penis.  Plast Reconstr Surg. 1994;  93 408-412
• 4 Hallock G G. Transient single-digit ectopic implantation.  J Reconstr Surg. 1992;  8 309-311
• 5 Graf P, Groner R, Horl W. Temporary ectopic implantation for salvage of amputated digits.  Br J Plast Surg. 1996;  47 174-177
• 6 Yousif N J, Dzwierzynski W W, Anderson R C, Matloub H S, Sanger J R. Complications and salvage of an ectopically replanted thumb.  Plast Reconstr Surg. 1996;  97 637-640