Post-Operative Recovery Concerns After Finger Amputation

Postoperative recovery issues following finger amputation?

Hello Doctor, I had an accident in mid-January where the tip of my finger was crushed by a machine.
After being taken to the hospital, the doctor assessed that the chances of reattachment were low, so I opted to forgo the procedure.
Post-surgery, the doctor explained that they attempted reattachment, but the severed finger continued to turn black.
I was instructed to observe the finger after discharge, provided there was no discharge or fluid.
However, it has been one and a half months, and the finger is completely black, with sensations of numbness and tingling.
How much longer should I observe this? Is it possible that the finger has necrosed? Should I seek treatment at another hospital? Thank you.

Jie, 30~39 year old female. Ask Date: 2021/03/01

Dr. Zhou Hongzhang reply Plastic Surgery

1.
It has been a month and a half; if there is no color change to a healthy pink, it is likely necrotic.

2.
At this point, considerations should include: how much length to amputate, and whether skin grafts or flaps are necessary.

3.
You can consult a plastic surgeon to discuss which surgical options may be most suitable.

Reply Date: 2021/03/01

More Info

Post-operative recovery after a finger amputation can be a complex and concerning process, especially when complications arise such as necrosis (tissue death) or persistent pain. In your case, where the fingertip was crushed and subsequently underwent an attempted reattachment, the symptoms you are experiencing—blackening of the tissue, numbness, and tingling—are indeed alarming and warrant careful consideration.

Firstly, the blackening of the fingertip is a significant indicator that the tissue may not be receiving adequate blood supply. This can occur due to several reasons, including vascular compromise during the surgical procedure, the severity of the initial injury, or complications arising from the reattachment attempt. When tissue does not receive sufficient blood flow, it can lead to necrosis, which is irreversible damage. The presence of numbness and tingling suggests that there may also be nerve involvement, which can occur if the nerves were damaged during the injury or if there is swelling or pressure on the nerves post-surgery.

In terms of how long to observe the condition, it is critical to follow up with your healthcare provider as soon as possible. Generally, if there is no improvement in the condition of the finger after a few weeks, or if symptoms worsen, further evaluation is necessary. This may include imaging studies, such as an ultrasound or MRI, to assess blood flow and tissue viability. If the tissue is indeed necrotic, surgical intervention may be required to remove the dead tissue and prevent infection.

It is also important to consider the potential for infection, especially if the area is discolored and painful. Signs of infection can include increased redness, swelling, warmth, and discharge from the wound site. If you notice any of these symptoms, it is imperative to seek medical attention immediately.

Regarding your question about whether to seek treatment at another hospital, if you feel that your current healthcare provider is not addressing your concerns adequately or if you are not receiving the necessary follow-up care, it is entirely reasonable to seek a second opinion. A different medical team may provide new insights or treatment options that could be beneficial.

In conclusion, your symptoms of blackening, numbness, and pain in the fingertip after an attempted reattachment are concerning and should not be ignored. It is crucial to have a thorough evaluation by a healthcare professional who can assess the viability of the tissue and determine the best course of action. Do not hesitate to seek further medical advice if you feel your current situation is not improving or if you have ongoing concerns about your recovery. Your health and well-being should always come first, and timely intervention can make a significant difference in outcomes after such injuries.

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