American Society of Hirudotherapy

Indications for replantation and revascularization in the hand

Review published in Hand Clin (2019)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical LiteraturePet MA et al. · Hand clinics, 2019

Abstract

The indications for upper extremity replantation are fluid, and it has long been appreciated that they change with time. Traditional strong indications for replantation include hand, thumb, or multiple digit amputation in adults, and almost any amputation in a child. Patients often desire replantation of single nonthumb digits based on aesthetic preference and personal/cultural values. Replantation in these situations is acceptable and rewarding, but individual consideration of patient, injury, and circumstantial factors is critical to avoid patient morbidity and unsatisfactory outcomes.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsAge FactorsAmputation, TraumaticComorbidityContraindications, ProcedureCultureEmploymentHand InjuriesHealth Services AccessibilityHumansMicrosurgeryOccupationsPatient PreferenceReplantationTime-to-Treatment

Summary

This review discusses evolving indications for upper-extremity replantation, from traditional strong indications such as thumb and multiple-digit amputation to single nonthumb digits replanted for aesthetic, personal or cultural reasons.

Context

This article discusses indications for upper extremity replantation, noting traditional strong indications (hand, thumb, multiple digit amputation in adults; nearly any amputation in children) and that patient preference and cultural values can influence decisions to replant single nonthumb digits. The abstract makes no mention of leeches, hirudotherapy, or the leech secretome, and offers no data on adjunctive therapies or outcomes. Based on the abstract provided, the article addresses factors influencing replantation decisions.

Citation

Reference (Vancouver style)

Pet MA, Ko JH. Indications for replantation and revascularization in the hand. Hand Clin. 2019;35(2):119-130. doi:10.1016/j.hcl.2018.12.003. PMID: 30928045

Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.

DOIPubMed

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.