This chapter presents a case scenario of a 20‐year‐old male carpenter with a traumatic amputation of the index and long digits of his dominant hand in a table saw accident. Though bone, tendon, and nerve repair correlates with long‐term functional outcomes, venous outflow remains the most important factor influencing replantation success in the immediate postoperative period. Anticoagulant/antithrombotic therapy has the potential to improve outcomes following digital replantation by inhibiting thrombus formation. There is a paucity of evidence addressing the topic of anticoagulation following digital replantation. Extensor and flexor tendon range of motion requirements in replantation can be conflicting. There is limited evidence supporting the use of prophylactic antithrombotic therapy following digital replantation. In cases of distal digital amputation, controlled continuous heparinization has a higher replantation success rate than intermittent bolus heparinization. The chapter provides recommendations for implementing evidence‐based practice in the clinical setting.