For the first time, Vietnamese doctors successfully performed microsurgery to 'save' a patient's severed finger after 25 hours.

While on duty on an ocean-going ship, sailor D had a serious accident. Storm No. 12 hit, causing the ship to rock violently at the time when D was repairing equipment. The impact caused his finger to be severed...

Storm No. 12 made landfall, causing the ship to rock violently at the time when Mr. D was repairing equipment. The sudden impact caused his right index finger to be severed. Fortunately, the crew on board quickly provided first aid and preserved the severed limb, placing it in a thermos, bringing him ashore and reaching the nearest medical facility in the Central region. At this time, the storm and wind were strong, bringing Mr. D ashore was really difficult and required great support from the national search and rescue agency.

In the emergency situation, after receiving first aid from medical staff, Mr. D wanted to have his severed limb reattached, so he and his family decided to take the earliest flight from Da Nang to Hanoi early the next morning to Viet Duc Friendship Hospital. The total time of anemia was up to 25 hours.

The surgical team performed microsurgery to reattach the patient's finger using a microscope. Photo: BVCC

Two parallel surgical teams determined to 'save' sailor's severed finger

At Viet Duc Friendship Hospital, experts evaluated the severed limb and noted: the severed limb had been properly treated and preserved, the finger joints were still soft, and the tissue structure was well preserved.

The hospital immediately held a multidisciplinary consultation including cosmetic plastic surgery, anesthesia and resuscitation, and orthopedic trauma to come up with an optimal treatment strategy and decided to perform microsurgery to reattach the patient's finger.

In the operating room, the emergency surgical team was deployed with the coordination of many specialties: microsurgery, anesthesia, resuscitation, orthopedics... Two surgical teams were deployed in parallel, one team cleaned and prepared the severed finger, the other team prepared the stump.

The finger bone is positioned and fixed with a specialized needle to create a stable axis, the tendon and ligament system is restored. In particular, the nerves and tiny blood vessels of only about 0.8 - 1mm are restored with high precision under a surgical microscope with special tools to ensure the restoration of blood circulation to the severed part.

This is a technique that requires the highest level of sophistication, because if just one blood vessel connection is not open, blood cannot nourish the fingertip and the limb will become necrotic.

In the case of record ischemia lasting 25 hours, from the amount of blood perfusion to the temperature of the finger, control of the risk of vasospasm and monitoring of postoperative peripheral circulation to ensure complete recovery of the finger.

The surgery was successful with the finger reattached after 25 hours. Photo: BVCC

There are many special things about limb reattachment...

Dr. Vu Trung Truc - Deputy Head of the Department of Maxillofacial, Plastic and Aesthetic Surgery, Viet Duc Friendship Hospital, who directly performed the surgery, shared that this is an extremely special case.

In limb reattachment, prolonged ischemia is often a major obstacle. Before surgery, the patient and the severed body part must be evaluated by an experienced multidisciplinary team.

"In this case, thanks to the proper preservation of the severed limb at the scene, the finger joint did not stiffen due to being preserved at the right temperature. Another factor is that the finger structure (including: bones, skin, nerves, blood vessels) has the ability to withstand anemia better than the limb with more muscles, so the finger was anemic for 25 hours but could still be reattached.

At the same time, the team of experienced doctors and good coordination between specialties are also the strengths of the hospital. These are the major factors that determine the success of the surgery" - Dr. Vu Trung Truc said.

After surgery, the wound has healed, the finger is pink and completely alive, the patient can have the stitches removed and the fixing needle removed. The patient is undergoing rehabilitation exercises to regain the mobility and feeling of the finger.

Accidents that cause severed fingers, hands or other body parts can happen at any time, from work accidents, household accidents to accidents at sea like the case of patient D.

Dr. Vu Trung Truc - Deputy Head of the Department of Maxillofacial, Plastic and Aesthetic Surgery examines the patient after surgery. Photo: BVCC

Therefore, experts recommend that people need to equip themselves with proper first aid knowledge, because this is the deciding factor in the ability to save a limb:

• Do not wash or soak the severed limb in any solution. In case the severed limb is in a dirty environment with many foreign objects, it can be washed under clean running water, preferably purified drinking water or boiled and cooled water.
• Wrap the limb with clean gauze/towel, put it in a nylon bag and tie it tightly (avoid direct contact with ice).
• Place the bag containing the limb into another bag containing ice.
• Keep the limb in a clean, temperature-controlled environment and transport it as quickly as possible.
• Take the victim to the nearest medical facility for treatment and further instructions.
• Do not self-treat, do not use drugs or disinfectants on severed limbs.

Experts from Viet Duc Hospital also emphasized: Proper first aid increases the chance of saving a severed limb. Being equipped with first aid knowledge, calmly handling and preserving it right at the scene significantly increases the success rate of surgery, helps restore function and aesthetics, and reduces the risk of disability for accident victims.

Source: https://suckhoedoisong.vn/lan-dau-tien-bac-si-viet-nam-vi-phau-thuat-thanh-cong-cuu-ngon-tay-benh-nhan-dut-roi-sau-25-gio-169251209173805688.htm