Digital amputation has an important social implication. One of the most important factor in replant success is the ischemia time. A referral system for replants becomes mandatory. We conducted a retrospective study over 5 years. The number of replantation, delay of referral, hospital stay and the time off work were evaluated. We found 116 digit done: 80 replanted and 36 revascularized. There was a difference of 2 h 20 min delay time between the direct and indirect referral to our hospital. The fingers who survived had 1h 45 min less ischemia time. There was an important difference between the delay time of the fingers who survived and the one failed. So to improve survival, a good referral system is of primary importance. The best replant system should imitate the trauma system where the patient is referred directly to a replant center with the minimum delay. The replant center should have qualified microsurgeons as well as a multidisciplinary approach to provide the acute and long-term care.