Psychiatric aspects of replantation surgery.

The surgical literature on replant patients was reviewed and reports of psychiatric complications were noted. Data for this study were obtained from semistructured psychiatric interviews administered to 30 replant patients within a few days of admission. In addition, 24 of the patients received two or more follow-up interviews. Thirty-three percent of the patients showed evidence of preaccident psychopathology; 20% suffered from a substance use disorder. Fifty percent of the patients reported a stressful life event within the year antedating the accident. Sixty percent of the patients were assessed as warranting psychiatric intervention. The presence of preaccident psychopathology, family or marital dysfunction, previous psychiatric history, and a stressful life event were all positively associated with the occurrence of an adverse postoperative emotional reaction. Case material is presented to illustrate specific psychological issues of replantation surgery, such as those concerning body image and the disruption to body integrity. Suggestions for further research are given.