Decision making in major upper extremity replantation based on evidences and experiences

Replantation of major upper extremities is a complex surgical procedure requiring meticulous decision-making and advanced skills. This retrospective study, conducted at a dedicated trauma center, reviewed 95 upper extremity replantation’s performed between January 2019 and March 2024. The study analyzed patient demographics, injury characteristics, surgical procedures, and outcomes to identify key factors influencing replantation success. Results showed a high success rate (95%) with significant functional recovery in most cases, despite some limitations in hand function. Factors such as age, level of amputation, ischemia time, and ancillary procedures were critical in determining outcomes. The study underscores the importance of comprehensive surgical and postoperative care, highlighting the superiority of limb salvage over prosthetic use. These findings provide valuable insights for optimizing decision-making and improving patient outcomes in major upper extremity replantation.