Reattach two severed legs

Recently, Mr. D.HH (38 years old, Thai Binh ) while repairing a machine, accidentally stepped into the mold of the fabric press when turning on the test switch. The mold immediately severed both of his legs and he was given first aid by the workshop workers to stop the bleeding on the spot, then transferred straight to the 108 Central Military Hospital.

At the 108 Military Central Hospital , Dr. Nguyen Viet Ngoc - Department of Upper Limb Trauma and Microsurgery, Institute of Orthopedics and Traumatology (CTCH) directly examined and performed the surgery . The surgery was performed by 2 surgical teams continuously for about 6 hours. After the surgery, the patient was transferred to the Emergency Resuscitation Department for monitoring and resuscitation treatment due to the large amount of blood loss immediately after the injury and the reperfusion status of the 2 lower legs after replantation.

After 2 days of recovery, the patient was stable and transferred to the Department of Upper Limb Surgery and Microsurgery for continued treatment. On the 6th day after surgery, the patient's general condition had recovered well, blood volume returned to normal, hemodynamics were stable; the surgical wound was dry, the toes on both sides were warm and pink with good reflux, the dorsum of the foot - calcaneus pulse was unclear. The prognosis was favorable.

The patient continued to receive antibiotics and anticoagulants for about 10 days after surgery, with daily wound care and dressing changes, and was expected to be discharged from the hospital.

According to Dr. Nguyen Viet Ngoc, the situation of severed limbs due to unsafe work practices is very common, but the case of severed both legs is very rare and this is the first case of replanting both legs on a patient in Vietnam. The surgery was carried out very urgently, only 1 hour after being admitted to the hospital, the patient had basic tests and was taken to the operating room. The process of arranging the surgical team was quick, the surgical method was reasonable so both legs were reperfused early in the 6th and 7th hours after the injury (only 1-2 hours after the surgery).

According to Dr. Nguyen Viet Ngoc, for large severed limbs and severed limbs at the same time on a patient, replanting the limb needs to be carefully calculated, because if not careful, it will endanger the patient's life due to reperfusion syndrome accompanied by toxins decomposing from the severed limb tissue. This is a case that the team carefully calculated, with reasonable treatment tactics, and performed by 2 surgical teams at the same time to minimize reperfusion time. The surgery was performed successfully as planned, currently the patient's blood supply to the replanted limb is very good and stable, he can flex his toes, and the prognosis for functional recovery is good.

News and photos: THUY NGOC

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