A severed finger is a profound injury. The immediate steps taken greatly influence the possibility of successful reattachment, or replantation. Time and proper handling are the most relevant factors for preserving the tissue’s viability. Understanding the correct first aid procedure for both the injured person and the severed part is paramount until professional medical assistance arrives.
Immediate Focus: Stopping the Bleeding
The first priority is to stabilize the injured person and control blood loss. Apply firm, direct pressure to the stump using a clean cloth or sterile dressing to compress the severed blood vessels. Simultaneously, raise the injured hand above the level of the heart, as gravity helps slow the flow of blood. Avoid lifting the dressing to check if the bleeding has stopped; if blood soaks through, place another layer on top and continue compression. A tourniquet should be avoided unless the hemorrhage is completely uncontrollable, as it can cause significant damage.
Preparing the Amputated Finger for Transport
Once bleeding is controlled, attention shifts to preserving the severed digit. If the finger is visibly soiled, gently rinse it with clean water or a sterile saline solution for a few seconds to remove contamination. Do not scrub the tissue or use harsh chemicals, as this damages the delicate cells needed for replantation. Loosely wrap the part in gauze or a clean cloth lightly moistened, ideally with saline solution. Place the wrapped finger inside a sealed, watertight container or plastic bag; this packaging protects the tissue from direct contact with ice and water.
The Danger of Direct Ice Application
Placing an amputated finger directly on ice is incorrect and can ruin the chance of reattachment. Direct contact with ice causes the tissue to freeze, leading to cold injury and frostbite, which destroy the cell structure. Frozen tissue is not usable for replantation because the microscopic damage makes it unviable. The goal is to cool the tissue, not freeze it, which slows the metabolic rate and extends the time the tissue remains viable (warm ischemia time). The correct method is a double-bag system: place the sealed bag containing the wrapped finger into a second, larger container filled with a mixture of ice and water. This slush mixture maintains the optimal temperature of about 4 degrees Celsius (39 degrees Fahrenheit) for preservation.
Coordinating Emergency Transport
Proper preservation requires rapid transport to a medical facility capable of performing microvascular surgery. Contact emergency services immediately and inform the operator that a traumatic amputation has occurred. The injured person and the preserved severed part must travel together to the hospital. Note the exact time the injury occurred when communicating with medical personnel, as this allows the surgical team to calculate the total warm ischemia time. While successful replantation has been reported up to 12 hours with proper cooling, the sooner the procedure is performed, the better the outcome.