American Society of Hirudotherapy

Managing vascular compromise of hand and digit replantation following traumatic amputation

Nursing review published in Br J Nurs (2018)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportSafety & Infection ControlClinical TrialsSpiers E · British journal of nursing (Mark Allen Publishing), 2018

Abstract

Hands are anatomically complex and have great social, physical and emotional importance. Hand or digit replantation following traumatic partial or complete amputation is a complex injury for nursing staff to understand and manage. The absence of clear guidance, combined with a lack of consensus in the literature gives rise to ambiguity and insufficient understanding of appropriate and effective management. This article aims to outline nursing care of the patient in the first few days following hand or digit reattachment, particularly focusing on the recognition and management of arterial and venous compromise. Complications must be recognised and acted on quickly to give the best chance of survival so it is essential for nurses to have an accurate understanding of the signs, symptoms and management options of vascular compromise. Leech therapy, also discussed, has long been used as a nonsurgical option in the management of venous congestion and is a simple and minimally invasive method of managing congestion.

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

Publication typeJournal Article
Indexed MeSH termsAmputation, TraumaticFinger InjuriesFingersHandHand InjuriesHumansPostoperative ComplicationsReplantationVascular Diseases

Summary

Nursing-focused review of vascular compromise recognition and management in hand/digit replantation, including MLT as a minimally invasive option for venous congestion.

Why This Matters for Hirudotherapy

This article outlines nursing care in the early postoperative period following hand or digit replantation, focusing on recognition and management of arterial and venous compromise, and mentions leech therapy as a long-established, simple, and minimally invasive nonsurgical option for managing venous congestion. The article is relevant to ASH's domain insofar as it discusses leech therapy within the context of post-replantation care. However, leech therapy is only briefly mentioned as one of several management options, the article's primary focus is nursing management of vascular compromise broadly, and no detailed data on leech therapy outcomes, protocols, or complications are provided.

Citation

Managing vascular compromise of hand and digit replantation following traumatic amputation.

Spiers E · British journal of nursing (Mark Allen Publishing), 2018

Added to ASH library: May 26, 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.