Pain control (Digital block)
Irrigate and debride non-viable tissue
Replantation rarely indicated for zone I-III amputations
Patients more likely to benefit from replantation for thumb and index finger amputations
Zone I injuries - treat conservatively with serial dressing changes alone
Cover wound with non-adherent dressing
Instruct patient to soak<unk>  in antibacterial soap-added water for 10min QD and then reapply non-adherent dressing
Follow up with primary care provider in 2d
Most will have epithelialization in approximately 1 month
Cover wound with non-adherent dressing
Instruct patient to soak<unk>  in antibacterial soap-added water for 10min QD and then reapply non-adherent dressing
Follow up with primary care provider in 2d
Most will have epithelialization in approximately 1 month
Zone II injuries
Consider hand surgery consult
Rongeur bone if bony protuberance
Trim digital nerves proximal to skin to avoid painful neuroma formation
Consider nail removal if significant involvement, possibility of hook nail deformity it damaged nail left in situ
Conservative treatment with non-adherent dressing generally preferred vs. wound closure with flap
Follow up with hand surgery in 3-5d
Healing time 3-6wks
Zone III injuries
Consult hand surgery if available
May require distal phalanx amputation
Consider treating like Zone II
Healing time 3-6wks
Consider hand surgery consult
Rongeur bone if bony protuberance
Trim digital nerves proximal to skin to avoid painful neuroma formation
Consider nail removal if significant involvement, possibility of hook nail deformity it damaged nail left in situ
Conservative treatment with non-adherent dressing generally preferred vs. wound closure with flap
Follow up with hand surgery in 3-5d
Healing time 3-6wks
Consult hand surgery if available
May require distal phalanx amputation
Consider treating like Zone II
Healing time 3-6wks
Fingertip avulsion
Distal interphalangeal dislocation 
Ring avulsion injury
Distal phalanx 
Degloving injury
Finger amputation
Scapholunate dissociation
Toe fracture