Mangaluru: A challenging and rare surgery of rejoining of four amputated fingers has been successfully performed by the Plastic Surgery Department at AJ hospital.
The patient, Sandeep (28 years) while working at Padubidri sustained accidental trauma to his left hand resulting in amputation of all four fingers. All four amputated fingers were successfully rejoined by Microvascular surgery, which lasted for six hours.
The Microvascular surgery was conducted by the Head of the Plastic Surgery Department Dr Dinesh Kadam, along with Dr Sanath Bhandary, Dr Rajesh Hukkeri and anaesthetist Dr Trivikram Tantry.
Hand injuries continue to dominate workplace accidents and amputations result in severe incapacitation and disability in young men. In this rare injury, all four fingers were completely separated from the hand and were restored successfully with microvascular surgery.
Successful re-plantation or rejoining of amputated parts requires repair of all structures including bone, tendons, nerves, blood vessels and skin. The most critical step in this procedure is the restoration of blood circulation in each of the fingers with repair of multiple tiny blood vessels under high magnification operative microscope. Equally important is continuous post operative monitoring of blood circulation in these fingers. Once the survival of rejoined fingers is ascertained, gradual and sustained physiotherapy is started to restore finger motion and optimal functional results. The successful outcome depends on many variables like the type of injury (crush or clean amputation), timing of injury, mode of preservation while transport, availability of expertise and technical difficulties during surgery. The procedure itself takes several hours to perform under the operative microscope.
It is urged that the amputated parts are to be transported in a clean polythene bag which is sealed tightly and placed in a container with ice containing water. The parts should not be in direct contact with ice or water.
The Department of Plastic Surgery established 12 years ago under Prof Dinesh Kadam has performed over 12,000 plastic surgical procedures including Cosmetic, Reconstructive and Microvascular surgeries. It is the first department in Mangaluru to start a Super-speciality – M.Ch course (after MS degree) recognized by the Medical Council of India. The department also provides free surgical treatment for children with Cleft Lip and Palate deformity in collaboration with The Smile Train.
