The year was 1814. Since then, advances in microsurgery have taken Dr. Balfour's landmark achievement to amazing new levels. Today's hand surgeons rely on ever-improving specialized microscopes and microsutures to ensure proper blood vessel, tendon and bone connections. Many hospitals have the equipment and physician expertise to successfully reattach amputated digits. With this escalating number of reattachment surgeries comes a corresponding need for hand therapists with skills to maximize outcomes.
Surgery is only as successful as the rehab that follows.
Calif. Cresswell watches for telltale signs of infection, such as redness, swelling, pain and heat at the wound site. Report anything suspicious immediately to the surgeon. Infections aren't normal, says Cresswell, who also watches for color changes, which indicate circulatory difficulty. A bluish or purple tinge indicates venous congestion, while a pale hue might mean inadequate blood inflow. While the patient is still in the hospital, inpatient therapists should begin light movements, usually on the first day postop to encourage blood flow to the freshly replanted digit.