Docs reattach severed fingers of farmer

ST CORRESPONDENT
Saturday, 16 February 2019

Dr Saxena emphasised that many of the severed body parts can be reattached, thus preserving the quality of life of patients through improved function and appearance.

PUNE: A 70-year-old farmer from Baramati was injured while he was operating a machine on his farm on January 26. All his fingers got severed in the accident. Only the little finger was hanging by the skin. Following first aid at a private hospital, he was brought to a city-based hospital on the same day. Dr Sumit Saxena, plastic and cosmetic surgeon at the hospital, used micro-surgery and reattached the fingers successfully.

Explaining the complexity of the surgery, Dr Saxena from Inamdar Hospital, where the surgery took place, said that carrying out multiple finger re-implants, and that too, in case of the middle of proximal phalanx, is a tricky and a difficult operation.

“However, now with the advancement in microsurgery, it is possible to reimplant a totally severed finger by restoring blood supply and repairing tendons, nerves, bones, etc,” said Dr Saxena. He added that the reimplant procedure was started immediately.

“Necessary investigations were done. Later, anaesthesia was given to the patient. The operation started immediately on the same day without wasting time. This procedure took 11 hours and finished on January 28 at 4.30 am,” said Dr Saxena. A team of doctors worked along with Dr Saxena. He said the patient was discharged after a week.

“At the time of discharge, there was movement in the fingers. The patient was advised on the need for a regular follow-up to assess the vascularity, bony union, range of motion and nerve recovery. Further procedures that may be required for the tendons, including tenolysis / transfers, neurolysis for the nerves and prolonged physiotherapy during the next one year have been explained to the patient,” said Dr Saxena.

NEED TO PRESERVE AMPUTATED PARTS
Dr Saxena emphasised that many severed body parts can be reattached, preserving the quality of life of patients through improved function and appearance.

“Success of the operation depends on factors like nature of the injury such as crush or sharp cut injuries, warm ischemic time, duration between time of amputation and time of re-implant, age of the patient, smoking habit, pre-existing diseases like diabetes, site of injury, contamination, etc,” said Dr Saxena.

He added that first aid should be given immediately. The injured hand should be wrapped in a clean dressing and elevated with direct pressure applied to limit bleeding.

“The amputated part should be retrieved, even if it appears unlikely that reimplant is possible. The amputated part should be wrapped in a saline-moistened gauze sponge and should be placed in a plastic bag,” said Dr Saxena.

He added that the replanted part never regains 100 per cent of its original use and most doctors consider 60 per cent to 80 per cent of use an excellent result.

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