Next the tendons are repaired. Repair of the delicate nerves, arteries and veins is done in the last stage of the procedure. These repairs are performed under operating microscopes, using microsurgical techniques. In sever injuries, vein or skin grafts are taken from another site, such as the forearm, foot or thigh. Vein grafts help to replace missing segments of arteries or veins.
Skin grafts are necessary when the injury or swelling prevents the skin edges from closing.
The patient's room is kept very warm after surgery to keep blood vessels dilated and to prevent blood clot formation. Blood thinning medication is required for up to a week after surgery. This medication prevents clot formation, a major cause of replantation failure. Smoking and drinking caffeinated beverages is restricted for three weeks from the time of surgery. Smoking and caffeine can increase chances of clot formation in the repaired vessels leading to failure of the replant.