If a finger or toe is cut off, press the wound to stop the bleeding, wrap the severed part in damp gauze and put it in a sealed bag, put the bag in ice water, and go to a hospital with a hand surgery department

In a real emergency, call 911 first, then read this.

Cost

Free. Keep a pack of clean gauze and a few sealable plastic bags at home. The hard part is that in the panic you have to care for the person first and the severed finger second, and resist burying the finger directly in ice or soaking it in water.

What you get

The MedlinePlus first-aid page of the U.S. National Library of Medicine says: press directly on the wound with your hand to stop the bleeding, and raise the injured part. A tourniquet may be used for life-threatening bleeding. Keep the severed part and take it along with the person. If the cut end is dirty, rinse it gently first. Wrap it in a clean damp cloth, put it in a sealed plastic bag, and put the bag in ice water. If it isn't in a bag, don't put it in water or ice, and don't put it directly on ice. Don't use dry ice, which will freeze the finger. If there is no cold water, just try to keep it from heat. Keeping it cold lets the finger wait longer; uncooled, it can be reattached for "only about 4 to 6 hours." Don't think the severed part is too small to keep. Don't push the severed part or bone back in. The fingertip amputation page of the American Academy of Orthopaedic Surgeons says the same, and adds that it is best to go to a hospital with a hand surgeon on duty at all times. Across 31 studies, 86.8% of replanted fingers survived (1976 fingers succeeded, 300 failed). Of 1087 people who had replantation, 82.9% went back to work. Another pooled analysis of 12 studies found a replanted finger survival rate of 85.3%. A further pooled analysis of 12 studies and 3645 people found that fingers with 8 or more hours of ischemia before surgery were more likely to die after replantation. The odds were about 2.25 times those of fingers under 8 hours: OR 2.25, 95% CI 1.43 to 3.54 (confidence range)

Notes

Graded B because the preservation method comes from guideline and textbook consensus, and the survival rates from studies that only followed and recorded cases. No controlled trial comparing different preservation methods was found. The size of the benefit is rated medium by judgment: what is saved is the finger, not life. Whether a reattachment is possible and worth it is for the doctor to decide from the injury; crushed or torn-off parts are harder to reattach than cleanly cut ones. MedlinePlus also reminds that saving life matters more than saving the severed finger: stop the bleeding first, then deal with the finger. If the bleeding can't be stopped by pressing, for how to apply a tourniquet see §13.12 (for heavy bleeding, first press hard on the wound with your hand). Chopping vegetables at home, fingers caught in door gaps and power tools can all cut off a finger. For protection when using an angle grinder, see §1.42 (fit the guard before using an angle grinder). The beneficiaries are mainly you and your family, especially people who often use power tools or do manual work.

Evidence grade

B : Supported by research but without a precise number, or based on small or single studies.

Sources

1. MedlinePlus (2024). Traumatic amputation：「Wrap the severed part in a clean, damp cloth, place it in a sealed plastic bag and place the bag in an ice water bath」「Do not put the body part directly in water or ice without using a plastic bag」「Do not put the severed part directly on ice」「Without cooling, the severed part is only good for reattachment for about 4 to 6 hours」. https://medlineplus.gov/ency/article/000006.htm
2. American Academy of Orthopaedic Surgeons. Fingertip Injuries and Amputations：「Do not allow the amputated part to be in direct contact with ice」「Go immediately to the emergency room, preferably at a hospital that has hand specialists immediately available」. https://orthoinfo.aaos.org/en/diseases--conditions/fingertip-injuries-and-amputations
3. Treger D 等 (2026). Return-to-Work After Attempted Digit Replantation: A Systematic Review of 31 Studies. HAND. https://doi.org/10.1177/15589447241279445
4. Stone N 等 (2021). Comparing digital replantation versus revision amputation patient reported outcomes for traumatic digital amputations of the hand: A systematic review and meta-analysis. Microsurgery. https://doi.org/10.1002/micr.30738
5. Yu F 等 (2026). Risk factors associated with postoperative necrosis after digital replantation: a systematic review and meta-analysis. Frontiers in Surgery. https://doi.org/10.3389/fsurg.2026.1795247

Translated from the Chinese original. Original book, section 13, tip 47. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer