In certain acute situations, amputated digits may be needed for a replantation and normal function to be restored, but the medical services available to perform this operation at any one time are often rarely available. The most likely reason for this is a shortage of qualified microsurgeons, for example, because the microsurgeon may already be in the operating room with another patient when the ambulance crew brings in a patient with digit amputation. To address this problem, we implemented a “hotline for amputated digits” service, which is available 24 hours a day, 365 days a year, and answered directly by a plastic surgeon. An advantageous feature of the hotline is that it can streamline decision making regarding whether or not a patient needs to be admitted, without needing to coordinate with other services such as the bed managers or operating rooms.
The hotline contributed to regional medicine, but had several limitations including a shortage of microsurgeons and medical institutions equipped to support digit replantation. To resolve these problems, there is a need for improved coordination between the regional surgeons qualified in performing microsurgery and those medical institutions that are equipped to host these emergency procedures.