What is the recommended initial step when handling an amputated finger at the scene to maximize viability for reattachment?

• A. Wrap in moistened gauze, place in a sealed plastic bag, and immerse the bag in ice water
• B. Wrap in gauze and place directly in bed of crushed ice
• C. Wrap in dry gauze and place on room temperature shelf
• D. Wrap in saline-soaked gauze and place in a plastic bag at room temperature

Answer: (A)

Preserving the amputated finger for reattachment hinges on keeping the tissue hydrated, clean, and chilled without freezing. Wrap the part in moist sterile gauze to prevent drying, seal it in a plastic bag to protect it from contamination and leakage, and then place that bag in ice water. This combination cools the tissue toward 4°C while avoiding direct contact with ice, which can cause cold injury. Dry gauze or room-temperature storage accelerates tissue damage, and storing in a bag at room temperature does not provide adequate cooling. Directly placing the finger on crushed ice increases the risk of frostbite and cellular injury, making it less ideal.