Reimplantation and revascularization procedures are critical for patients with catastrophic hand injuries. This study aims to analyze the epidemiology, functional outcomes, and perceived quality of life in patients treated for upper limb reimplantation over the past three years.

We conducted a retrospective analysis of 157 patients. Data collected included epidemiological details, injury mechanisms, transfer times, and amputation levels. Functional outcomes and quality of life were assessed using an online questionnaire incorporating sociodemographic and medical variables, the Russell test for subjective functionality, the QUICK-DASH for hand functionality, and the SF-12 for quality of life. A cross-sectional, descriptive, analytical, and correlational study was performed.

Most patients were male (89%), with 30% being smokers or ex-smokers. Right-handed individuals comprised 92% of the sample, but the left hand was more frequently injured (50%). Ages ranged from 1 to 89 years, with a mean age of 45.5 years (SD=19.89). Patients from 20 provinces were included, primarily transferred by ambulance. The most common injury mechanism was a saw (41%), often mixed with other mechanisms. Injury distribution included 48 thumb injuries, 45 multiple finger injuries, and 23 proximal amputations. Over 60% of injuries were work-related. According to the questionnaire, 68% of patients returned to their previous work activities. Satisfaction ratings showed 50% of patients considered their outcome “very good”, 10% “good”, 24% “fair”, and 15% “poor”. Additionally, 90% believed their limb was better than a prosthesis. Reimplantation failures occurred within the first 24hours in 70% of cases. Of these, 31% were smokers, and nearly 40% had significant comorbidities. Partial necrosis occurred in 13% of cases, 6% experienced infection, and 3% had poor consolidation.

Measuring the quality-of-life post-reimplantation has proven invaluable in determining which cases benefit most from reimplantation versus those better managed with amputation. Standardized tools like the SF-12 and QUICK-DASH allowed us to assess functional outcomes and patient satisfaction objectively. Patients with significant comorbidities or smokers showed higher reimplantation failure rates, suggesting that primary amputation and early prosthetic fitting might lead to better quality of life and functionality in these cases. This approach enables clinicians to make more informed decisions, optimizing patient care and resource allocation.

Reimplantation and revascularization provide viable options for patients with severe hand injuries, with most patients reporting satisfactory outcomes. Future studies should focus on long-term functional results and quality of life improvements to further refine these procedures and its indications.