Houston Methodist. Leading Medicine

Hand FAQ

Question:

I'm doing a quick on-line search for my brother trying to find some information to help us. He had an accident at work and cut his ring finger off just above the main knuckle. The hand surgeon reattached the finger but it looks like blood is pooling where the finger was sewn back on. They are actually talking about using leeches to get rid of the blood. Is this for real?

Answer:

Modern microsurgery makes it possible to reattach severed fingers with good-to-excellent results most of the time. After reattaching the amputated finger, it is usually clear within a day or two if the replantation is going to be successful. Nursing and medical staff check frequently to see if skin color, temperature, and circulation are normal. Sometimes a problem called venous congestion can develop. Blood clots form in the veins making it impossible for blood to the replantation to return to the heart. Without proper blood circulation to and from the finger, the reattached (replanted) tissue starts to die. For mild problems, a quick and easy way to reduce the amount of blood pooling and remove the blood clot is with the application of leeches. Just as you might imagine, the leeches suck the pooled blood out from under the skin. But leeches aren't enough when there are blood clots forming, skin inflammation with blisters, and/or necrosis (dying tissue). There are other ways to surgically handle this situation. The surgeon usually chooses the least invasive method (leeches first if possible), then assesses the patient's individual factors in order to decide the next step (if a next step is needed). Jianyong Zhao, MD, et al. A Novel Solution for Venous Congestion Following Digital Replantation: A Proximally Based Cross-Finger Flap. In The Journal of Hand Surgery. July 2011. Vol. 36A. No. 7. Pp. 1224-1230.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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