Management of complex tissue injuries and replantation across the world.

Management of complex tissue injuries and provision of replantation services calls for the availability of a dedicated team with high skill levels and good infrastructure. Centres of excellence which provide consistent good care exist in many parts of the world, but large populations are still left uncovered. In the developed world, the reduced exposure to such injuries, lesser training opportunities and poor reimbursement for the efforts put in are the problems. In the developing countries, lack of awareness of the possibilities, inadequate transport systems and infrastructure are the problems. In both systems the cornerstone for improvement will be the availability of well trained surgeons who will deliver consistent good results. Public education and developing a team around the surgeon will improve the results in developing countries. Collaboration with good units with high volume load in the developing countries will be beneficial for training and maintainance of the required skill levels in the developed world.