The Problem

Acute hand trauma arrives where it arrives. A replantable amputation, a complex open fracture or a devascularised limb may present to a district hospital hours from the nearest microsurgical unit, to a surgeon who knows what is needed but not where to send it. Time lost at that point is function lost permanently.

What the Network Provides

• Referral contacts by governorate — which units accept acute hand trauma, and how to reach them out of hours
• Replantation capability — centres equipped and staffed for microvascular replantation
• Transfer guidance — preparation of the amputated part, warm and cold ischaemia limits, and what to document before transfer
• Advice line — access to a consultant for discussion of an acute case

Before You Transfer

Guidance on initial management — wound handling, splinting, antibiotic and tetanus cover, preservation of amputated parts, and the imaging and documentation that should accompany the patient — will be published here as a downloadable reference for emergency departments.

Joining the Network

Units willing to receive acute referrals are invited to register with the Society office, stating capability, catchment and out-of-hours arrangements.