IN GENERAL, a reattached appendage may have a 100% take of survival, a partial take, or a complete loss. In some cases, a partial take is very acceptable, since the portion that is missing may be able to be replaced from another source (ie. if only skin is missing, it can often be grafted).

With the above in mind, any amputated appendage, by definition has lost its blood supply. If this is not restored in a reasonable period of time, the tissue will die of hypoxia (loss of oxygen) and nutrients. To prolong the time the tissue can be kept unattached, the standard is to cool it as much as possible, without freezing it. Freezing causes the liquid parts of the cells to swell, as ice does in an ice cube container, which ruptures the cell wall, killing the cell. The best way to treat an amputated piece of tissue is to place it dry, into a plastic bag, and seal it. Then place that bag into a second bag filled with iced water. Saline, or salt water should never be used for the liquid, since the freezing point of salinated water is below 32°F, which could result in the above described death by freezing of the cells. Do not add saline to the first bag "to keep the specimen moist". It may lead to maceration of the tissues and make them unreplantable. The tissue will not dry out as long as the first bag is sealed.

The "clock begins ticking" the moment the appendage is amputated. A smaller appendage such as a finger or ear, may be kept viable (alive) for many hours. While there are claims that a specimen has been successfully replanted after 24 hours, the chances decrease significantly with prolonged ischemia (lack of oxygen). A reasonable goal should be 8 hours or less. Extra care must be taken with larger appendages to ensure that the entire limb or structure is kept evenly cold. While the surface may be cold, the interior may be warmer if there is not adequate cooling provided (ie. insufficient iced water to cover the entire area.)

After all of the above is taken into consideration, other factors that may lead to an unsuccessful reattachment have to be considered: The age, and general health of the patient; The condition of the proximal site (the area the appendage was amputated from); The availability of the equipment and/or personnel to actually perform the operation; The willingness of the patient to undergo the procedure and the postoperative rehabilitation.