Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.
  Table of Contents / Chapter 29:
Organization of the Replantation Unit
  While patients are in the hospital, the therapists perform initial splinting and therapy in close consultation with the surgical team. Upon the patient's discharge, the therapist arranges for follow-up care at either this center or a center closer to the patient's home. The therapist maintains close contact with the outside therapist to monitor the patient's progress and deal with problems as they arise. The patient is seen by a therapist during each clinic visit, and the therapist participates in decisions of adjunctive care, secondary surgery, and final disability evaluations. Support garments and prostheses are also coordinated through the hand therapy section.

Office and Clinic Personnel

These individuals receive the same training in forwarding emergency referrals as our emergency staff.

For clinic, the office staff assembles all patient charts a day ahead of time so that x rays, motor and sensory examinations, and other special evaluations can be organized. Our office staff also assists patients with problems of insurance forms, transportation, and local accommodations. Managing these details is complicated and time-consuming, and our office personnel solve these problems with high degrees of intelligence, perseverance, and ingenuity.

Voluminous patient-related correspondence, as well as manuscripts, are produced in the office by our transcriptionist, who uses a word processor and works closely with the physician and clerical staff to set priorities and coordinate distribution.


Replant Referral Coordinator

We have profited greatly from the services of a troubleshooter in the role of replant referral coordinator. The position is held by a registered nurse who has had many years of experience in our intensive care unit and microsurgical nursing floor.

The referral coordinator keeps a master file containing a record of all emergency referrals. He or she ensures that clinical reports are sent to referring physicians, and reviews each referral to see if any problems arose in communication and transport. While working with each individual referral, he or she develops general protocols for reception of telephone referrals, patient care instructions to referring emergency rooms, and initiation of transportation. Additionally, he or she regularly gives lectures on replantation to emergency room staffs within our referral area. These efforts have allowed us to minimize the effort necessary for an outlying emergency room to refer a patient to our center.


A professional photographer employed by the unit duplicates and distributes slides and prints, prepares prints for publication, and assists with special problems of presentations and exhibits.

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