Replantation is a surgical process to re-attach a separated body part by microsurgical techniques, aiming to re-establish circulation for survival of the detached part. Since the first replantation was being done in 1963 by Chinese Pioneer Dr Chen Zhong-Wei, there has been a lot of development. 1. Indication: With advancement in technology in surgical instrumentation and magnification, indications for replantation surgery may extend to very distal fingertip amputation, crushed injury or avulsion injury. 2. Refinement in surgical techniques: with better understanding of the anatomy, replantation is more easily to be done as those anatomical structures can be more easily identified. Use of volar veins improved the chance of success. One may also use artery to vein anastomosis in very distal replantation. Other adjunct procedures, such as venous flap or cross finger flaps may also improve survival rate. 3. Ectopic banking: It is a technique used for temporary nourishes the amputated part in a nonanatomical position when immediate replantation is not possible. It is hope later reconstruction is feasible after optimizing the wound condition. 4. Replantation Centers: There are well-established replantation centers in some countries. These established replantation centers would be more equipped with the necessary support for replantation surgery, from transport, post-operative monitoring and rehabilitation. These will also improve outcome of replantation surgery. Hong Kong may consider the development in this direction.
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