An overview of replantation and results of 347 replants in 245 patients.

A review of 245 patients requiring replantation surgery from 1970 to 1978 revealed a 70% survival rate for complete amputation. In this group, there were 347 replanted parts, including the lower extremity. Upper-extremity survival rates alone (greater than 90%) are higher than for lower extremity replantation. Meaningful assessment of replantation must include not only survival data but functional criteria as well. While functional data are incomplete on several early cases, our assessment criteria are reviewed. Criteria should include two-point discrimination sensibility ratings, grip strength, range of motion, absence of cold intolerance, and return to employment. Evaluation of candidates for replantation is critical, and the importance of teams with microsurgical skills working in special centers is emphasized.