Microsurgical replantation of severely crushed and contaminated amputated limbs in children: Case reports and surgical insights.

JPRAS open 2026 Vol.48() p. 662-668

Phan MDM, Nguyen PD

Abstract

Severely crushed and contaminated pediatric amputations present unique challenges for limb salvage, especially when critical structures are damaged. We report two pediatric cases-one hand and one foot amputation-successfully replanted using meticulous microsurgical techniques. A key component of our approach was microsurgical debridement under high magnification, which enabled removal of deeply embedded contaminants without sacrificing additional tissue. Both patients achieved limb survival and functional recovery after long-term follow-up. Detailed sensory outcomes, range of motion, skin coverage management, postoperative microbiological findings, and antibiotic regimens are presented. These cases underscore the importance of precise debridement, early revascularization, and comprehensive postoperative care in pediatric contaminated crush amputations.

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