The Birthplace of Limb Replantation: China's World-Leading Microsurgery Center
The Department of Replantation and Microsurgery at Shanghai Sixth People's Hospital — affiliated with Shanghai Jiao Tong University School of Medicine — holds a unique and historic place in the history of medicine. On January 2, 1963, surgeons at Shanghai Sixth People's Hospital performed the world's first successful replantation of a completely severed human limb — a landmark achievement that transformed reconstructive surgery globally and established Shanghai Sixth People's Hospital as the birthplace of modern replantation surgery. More than six decades later, the department remains China's undisputed national leader in replantation surgery and microsurgery, with a national and international reputation for excellence in digit and limb replantation, free flap reconstruction, vascularized composite allotransplantation, peripheral nerve surgery, and the management of complex upper extremity injuries.
For international patients who have sustained traumatic amputations, complex hand and upper extremity injuries, or who require advanced microsurgical reconstruction — Shanghai Sixth People's Hospital's replantation and microsurgery department represents the gold standard in China and one of the premier microsurgery centers in the world. China Medical Concierge Shanghai (CMCS) provides seamless end-to-end coordination for international patients throughout their microsurgical care journey at Shanghai Sixth People's Hospital.
About the Department
The replantation and microsurgery department is a national key clinical specialty and national microsurgery training center operating dedicated replantation surgical theaters with 24/7 emergency capability, a microsurgery research laboratory, a hand therapy and rehabilitation program, and works in close collaboration with hand surgery, orthopedics, vascular surgery, and rehabilitation medicine through a fully integrated multidisciplinary team. The department performs hundreds of replantation and microsurgical procedures annually, maintaining outcomes that benchmark against the world's best programs.
Faculty members publish regularly in leading microsurgery and reconstructive surgery journals including Microsurgery, Plastic and Reconstructive Surgery, Journal of Hand Surgery, Journal of Reconstructive Microsurgery, and Annals of Plastic Surgery.
Replantation Surgery
Digit Replantation
Shanghai Sixth People's Hospital's digit replantation program is one of the world's most experienced, with outcomes that set the global benchmark:
- Single Digit Replantation — Thumb replantation (highest priority — critical for hand function); index, middle, ring, and little finger replantation; zone I-V replantation; distal tip replantation; nail bed replantation
- Multiple Digit Replantation — Simultaneous replantation of multiple amputated digits; prioritization strategy; ectopic replantation for non-replantable digits
- Ring Avulsion Injuries — Urbaniak classification; replantation vs. revision amputation decision; vein grafting for avulsion injuries
- Pediatric Digit Replantation — Superior outcomes in children due to regenerative capacity; distal replantation in children; growth plate considerations
- Outcomes — Survival rates >90% for sharp amputations; functional outcomes benchmarked against international standards; two-point discrimination; grip strength; return to work
Hand & Wrist Replantation
- Transmetacarpal Replantation — Replantation through the metacarpal level; bone fixation; tendon repair; nerve and vessel repair
- Wrist-Level Replantation — Complex bone and joint reconstruction; carpal bone fixation; multiple tendon, nerve, and vessel repair
- Degloving Injuries — Replantation of degloved skin as composite graft; free flap coverage for non-replantable degloving
Major Limb Replantation
- Forearm Replantation — Bone shortening and fixation; muscle and tendon repair; median, ulnar, and radial nerve repair; arterial and venous reconstruction; fasciotomy for reperfusion
- Above-Elbow Replantation — Humeral fixation; muscle repair; brachial plexus nerve repair; brachial artery reconstruction; rehabilitation planning
- Lower Extremity Replantation — Below-knee and above-knee replantation; tibial and femoral fixation; nerve repair; vascular reconstruction; fasciotomy
- Ischemia Time Management — Cold ischemia tolerance up to 12 hours for digits; 6 hours for major limbs; rapid cooling protocols; temporary vascular shunting for major limbs
- Post-Replantation Monitoring — Continuous clinical monitoring; laser Doppler flowmetry; implantable Doppler; leech therapy for venous congestion; re-exploration for vascular compromise
Microsurgical Free Flap Reconstruction
- Anterolateral Thigh (ALT) Free Flap — Workhorse flap for extremity, trunk, and head and neck reconstruction; thin and thick variants; chimeric flap
- Radial Forearm Free Flap — Thin pliable flap for hand, intraoral, and pharyngeal reconstruction; sensate flap
- Lateral Arm Free Flap — For moderate-sized defects; sensate flap; minimal donor site morbidity
- Groin Free Flap — For hand and digit reconstruction; thin flap; concealed donor site
- Toe-to-Hand Transfer — Second toe transfer for thumb and finger reconstruction; great toe transfer for thumb reconstruction; wrap-around flap; trimmed toe transfer; one of China's most experienced toe transfer programs
- Vascularized Bone Grafts — Vascularized fibula for long bone reconstruction; vascularized iliac crest; vascularized medial femoral condyle for scaphoid non-union and avascular necrosis
- Perforator Flaps — ALT; MSAP; TDAP; propeller flaps for local reconstruction
Toe-to-Hand Transfer
Shanghai Sixth People's Hospital's toe-to-hand transfer program is one of China's most experienced and technically advanced:
- Thumb Reconstruction — Great toe transfer; wrap-around flap (Morrison); trimmed great toe transfer; second toe transfer for smaller thumbs; pollicization for congenital thumb absence
- Finger Reconstruction — Second toe transfer for single finger loss; combined second and third toe transfer for multiple finger loss; partial toe transfers for distal phalanx reconstruction
- Total Hand Reconstruction — Combined multiple toe transfers for total hand loss; functional hand reconstruction after traumatic amputation
- Outcomes — Sensory recovery; grip and pinch strength; dexterity; patient satisfaction; return to work
Peripheral Nerve Surgery
- Nerve Repair — Primary epineural repair; grouped fascicular repair; tension-free repair with nerve mobilization
- Nerve Grafting — Sural nerve graft; medial antebrachial cutaneous nerve graft; cable grafts for large gaps; processed nerve allograft (Avance)
- Nerve Transfer — Oberlin transfer (ulnar nerve fascicle to biceps) for brachial plexus injury; AIN to ulnar motor transfer; end-to-side nerve repair; supercharge nerve transfer
- Brachial Plexus Injury — Nerve exploration and repair; nerve grafting; nerve transfer (intercostal, phrenic, contralateral C7, spinal accessory); free functional muscle transfer (gracilis) for elbow flexion and hand function; one of China's most experienced brachial plexus surgery programs
- Free Functional Muscle Transfer — Gracilis free functional muscle transfer for brachial plexus injury; elbow flexion and finger extension restoration; double gracilis for complete brachial plexus palsy
Vascularized Composite Allotransplantation (VCA)
- Hand Transplantation — Evaluation and preparation for hand transplantation; immunosuppression protocol; rehabilitation; one of China's most experienced hand transplantation programs
- Indications — Bilateral hand amputation; unilateral amputation with prosthesis failure; young patients with high functional demands
- Outcomes — Sensory and motor recovery; immunosuppression management; quality of life
Emergency Replantation Service
Shanghai Sixth People's Hospital operates a 24/7 emergency replantation service, one of the busiest in China:
- Dedicated replantation surgical theaters available around the clock
- Experienced replantation surgical teams on call 24 hours a day, 365 days a year
- Rapid assessment and triage of replantation candidates
- Proper amputated part preservation guidance for referring hospitals and patients
- Helicopter and ambulance coordination for urgent transfers
- CMCS emergency coordination for international patients requiring urgent replantation
Replantation Rehabilitation
- Hand Therapy — Early mobilization protocols; edema management; scar management; splinting; sensory re-education; mirror therapy
- Occupational Therapy — Activities of daily living; adaptive equipment; return-to-work planning
- Sensory Re-education — Structured sensory re-education program after nerve repair; two-point discrimination training; texture discrimination
- Secondary Procedures — Tenolysis; capsulotomy; nerve grafting for poor recovery; toe transfer for failed replantation; prosthetic fitting for non-replantable amputations
Why International Patients Choose Shanghai Sixth People's Hospital Replantation
- World's First Replantation Center — Site of the world's first successful limb replantation in 1963; over 60 years of unparalleled experience
- China's National Leader — Undisputed national leader in replantation surgery; national microsurgery training center
- Toe-to-Hand Transfer Expertise — One of China's most experienced toe transfer programs for thumb and finger reconstruction
- Brachial Plexus Surgery — One of China's most experienced brachial plexus injury programs; free functional muscle transfer
- 24/7 Emergency Service — Round-the-clock replantation capability; CMCS emergency coordination for international patients
- Cost-Effectiveness — World-class microsurgery at significantly lower cost than equivalent treatment in Western countries
Amputated Part Preservation: Critical Instructions
If you or someone you know has sustained a traumatic amputation, proper preservation of the amputated part is critical for replantation success:
- Wrap the amputated part in a clean, moist cloth or gauze
- Place the wrapped part in a sealed plastic bag
- Place the sealed bag in a container of ice water (NOT directly on ice — freezing destroys tissue)
- Transport to Shanghai Sixth People's Hospital as quickly as possible
- Contact CMCS immediately for emergency coordination: WhatsApp +86 170 6215 3332
The CMCS Patient Journey
- Initial Inquiry — For emergency replantation: contact CMCS immediately via WhatsApp for urgent coordination. For elective microsurgery: share your condition, photographs, imaging, and prior surgical records with CMCS.
- Medical Record Preparation — We translate and organize your records for specialist pre-consultation review.
- Specialist Matching — We identify the most appropriate microsurgeon based on your needs — replantation, free flap reconstruction, toe transfer, nerve surgery, or brachial plexus injury.
- Priority Scheduling — We secure a consultation with minimal waiting time; emergency coordination available 24/7.
- Travel & Logistics — Assistance with visa invitation letters, accessible accommodation near Shanghai Sixth People's Hospital, and Shanghai airport transfers.
- Surgical Coordination — Full coordination of surgical admission and post-operative care.
- Rehabilitation Support — Coordination of hand therapy, occupational therapy, and sensory re-education program.
- Post-Discharge Follow-Up — Surgical report translation, rehabilitation guidance, and remote follow-up coordination after you return home.
Book a Consultation
If you have sustained a traumatic amputation, require toe-to-hand transfer, have a brachial plexus injury, or need advanced microsurgical reconstruction — CMCS can arrange urgent or elective coordination with Shanghai Sixth People's Hospital's world-leading replantation and microsurgery team.
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