Microsurgical imprints in the treatment of occupational accident injuries

Recently, medical facilities in Ho Chi Minh City have continuously handled many cases of limb reattachment due to work-related accidents. Successful limb reattachments represent a great effort from the medical team, but are also a warning to workers that every second of carelessness can cost them dearly in terms of their health.

Patient after limb reattachment surgery at Xuyen A General Hospital.

In early December, the Orthopedic Trauma Department of Cho Ray Hospital continuously turned on the lights to perform surgeries to reattach severed limbs for patients due to work accidents.

Dr. Tran Phuoc Binh, Department of Orthopedics, said the medical team had just gone through a particularly stressful week when they had to receive two patients with severed ankles and lower legs caused by lawn mowers. “Every minute of delay reduces the chance of survival of the tissue and blood vessels,” Dr. Binh shared.

The 57-year-old man from Ho Chi Minh City and the 46-year-old patient from Vinh Long province were admitted to the hospital with blood loss, their severed limbs were covered with sand, grass, and mud, and the journey took 4-6 hours.

A successful limb reattachment at Cho Ray Hospital.

These are unfavorable factors because the golden time to save a limb is only about 4 hours if the tissue is properly preserved. Therefore, as soon as the patient is admitted, the internal red alert procedure is activated. The surgical team of the Department of Orthopedics, Anesthesia and Resuscitation and Vascular Surgery quickly gets ready, mobilizing on-site microsurgeons to ensure that no more precious minutes are lost.

Surgery to reattach a severed limb is a very complex technique. Under a microscope, doctors must stitch up blood vessels smaller than a hair, rearrange bones, connect tendons and nerves. Each surgery lasts from 5 to 8 hours, requiring absolute expertise and meticulousness. “It must not only be fast but also extremely precise, any wrong operation can make the entire limb unable to survive,” Dr. Binh emphasized.

Doctor Tran Phuoc Binh, Department of Orthopedics and Trauma, Cho Ray Hospital talks about limb reattachment after a work accident.

Thanks to timely treatment, both patients were able to save their limbs and are recovering well. The successful surgeries also highlight many issues that need attention today, especially regarding occupational safety awareness and first aid skills at the scene.

In fact, many cases of patients being admitted to the hospital with severed limbs were placed directly on ice, causing tissue damage, or were placed in plastic bags without cooling. There were even cases where the tourniquet was applied for too long, causing the remaining limb to lack blood supply, leading to difficulties for the surgeon when performing limb reattachment surgery because it took more time to clean the crushed tissue and the surgery time was prolonged, reducing the chance of saving the limb.

Not only at Cho Ray, work accidents causing amputation of limbs also occurred in many other medical facilities. At Xuyen A General Hospital, a 35-year-old male worker B. suffered a serious accident when an industrial dryer rolled over and nearly severed his forearm. The accident occurred in a moment of carelessness, leaving behind serious consequences.

The surgical team at Xuyen A General Hospital reattached the forearm of patient B.

Colleagues temporarily bandaged the wound and took Mr. B. to the hospital, but the injured limb was still crushed, the tendons were twisted and almost intact.

Microsurgeons at Xuyen A General Hospital urgently treated the open fracture of the radius, ulnar styloid process, wrist dislocation and rupture of almost the entire extensor tendon system. Doctor Nguyen Thanh Thang, Department of Microsurgery and Orthopedics, said, “The tendons and muscles were crushed by the machine and are very difficult to recover. We had to selectively suture the most important tendon groups to maintain wrist function.”

Fracture image.

X-ray image of the bone after successful fusion.

Thanks to the blood vessels and nerves not being completely severed, combined with microsurgery techniques and specialized instruments, the 5-hour surgery was successful in helping the hand regain blood flow. After two days, the patient was able to move his fingers slightly, showing positive signs for the upcoming recovery journey.

These life and death stories show the remarkable progress of the final hospitals in handling serious trauma. However, according to doctors, it is the workers and the community that are the first factors that determine the success of the treatment. From many years of experience participating in hundreds of cases of severed limbs, Dr. Tran Phuoc Binh gives clear recommendations on the process of preserving limbs.

Wrap the severed limb in a clean cloth or sterile gauze, then put it in a sealed plastic bag and place it in an ice bath to cool evenly. Be careful not to place the limb directly on the ice.

For victims, it is necessary to stop bleeding quickly and properly, take the victim to the nearest medical facility for first aid and then transfer to a specialized facility. Try to shorten the travel time as much as possible because the golden time for limb reattachment is only 4-6 hours after the accident.

Doctors emphasize that work accidents with lawn mowers, industrial dryers or mechanical equipment can be completely prevented if workers follow operating procedures, use protective gear and do not work while tired or lacking concentration.

When an accident unfortunately occurs, it is necessary to stay calm and follow the correct first aid procedures. This is essential knowledge that workers and every family need to master to protect the health and safety of themselves and those around them.

NHAT THANH

Source: https://nhandan.vn/dau-an-vi-phau-trong-xu-tri-chan-thuong-tai-nan-lao-dong-post927794.html