Reporter Jiao Shouguang Correspondent Wang Jun
On April 7, a middle-aged man in Tai’an, Shandong was rushed to Shandong Province due to a broken right forearm machine. In the Department of Rehabilitation and Reconstruction Surgery of the Public Health Clinical Center, with the efforts of 8 doctors, the patient’s severed arm was successfully replanted and survived. At present, the patient has passed the dangerous stages of replantation of the severed limb. This is the center’s first limb amputation case.
Operating the machine resulted in amputation of the right forearm
The patient’s upper limb was completely amputated by the machine for 5 hours. When sent to the hospital, the skin and soft tissue of the severed limb had leather-like changes, the muscles, tendons, blood vessels and other soft tissues were avulsed, the bone was broken, and the severed limb had no blood supply.
The on-duty doctors Lv Zhengpei and Liu Na of the Repair and Reconstruction Surgery rushed to the emergency department to check the injury and immediately reported the condition to Liu Linfeng, the director of the department. Director Liu immediately reported the situation to the medical department of the center, and the medical department gave Guidance: While doing a good job in epidemic prevention and control, try our best to save the limbs of patients. The center immediately retained rapid nucleic acid for patients and their families and detected the results within 1 hour. At the same time, the green channel was opened, the ward buffer room was activated, and various preoperative preparations were improved.
Opening a green channel for emergency rescue, 8 doctors will “replant” the severed arm after 9 hours
Department of anesthesiology director Li Kezhong, head nurse in the operating room Gao Jianmei actively coordinated the operation-related matters, and arranged experienced anesthesiologists and surgical nurses, and the blood transfusion department in the center provided emergency blood preparation to provide safety guarantees for the operation.
The operation officially started at 21:30 that night. Dr. Lv Zhengpei, Liu Na, Wang Dingyi, Li Feng, Qin Yang, and Liu Shuang performed the operation in groups under the guidance of Director Liu Linfeng. The limb bones, blood vessels, nerves, and tendons were repaired and anastomosed one by one under the skillful hands of the repair and reconstruction surgeon, and the severed limb was successfully vascularized at 1:00 am the next day.
In anesthesiology, operating room With full assistance, after 9 hours, the patient’s right arm was successfully replanted. He returned to the ward at 7:20 the next day. The patient’s vital signs were stable, and the limbs were well ventilated.
The successful replantation of severe limb amputation is only the first key stage of limb survival, followed by the more important postoperative perioperative supportive treatment, to overcome such as reperfusion injury, anastomosis of blood vessels, etc. Dangerous periods such as spasm, postoperative incision infection, tissue ischemic necrosis, etc., and postoperative nursing observation is an important link to ensure the success of the operation. Head nurse Yang Xiuzhen reported the situation to Director Rong Ningning of the Nursing Department, and Director Rong overcame the center nurses during the epidemic. It was extremely difficult and difficult to send back many nurses who were transferred from the original department in time. This patient is the first case of complete amputation of the forearm in the center. For this purpose, the department has established a blood circulation observation and nursing team after the amputation of the large limb, and the specialist nurse Li Ranyue is responsible for technical guidance. Unified technical standards ensure 24-hour comprehensive and precise care for patients.
The patient has been 2 weeks after the operation, and the sutures have been removed. With great efforts, the patient has successfully passed through various stages of danger, including vasospasm, reperfusion injury, postoperative infection, and tissue necrosis, and the affected limb survives well.
This patient will undergo functional rehabilitation, reconstruction and other surgical and non-surgical treatments in the later stage. The center’s repair and reconstruction surgery team hopes that this patient can obtain satisfactory limb appearance and function.
Under the severe situation of epidemic prevention and control, the center quickly opened a green channel for critically ill emergency patients, so that patients can receive timely and effective treatment. The comprehensive rescue strength has reached the domestic advanced level.
Rehabilitation and Reconstruction Surgery Center>>
The internationally renowned hand microsurgery expert, Professor Wang Zengtao, was established in November 2021 and served as the special director of the department. Liu Linfeng, a core member of Professor Wang Zengtao’s expert team and a well-known hand microsurgery expert in China, serves as the director of the department.
The department has four centers including “Finger Reconstruction Center, Wound Repair Center, Lymphatic Surgery Center, and Breast Reconstruction Center”. Among them, the “Lymphatic Surgery Center” was founded by Professor Wang Zengtao, the former chairman of the World Society for Reconstructive Microsurgery (WSRM) and the world authority on lymphedema repair, to create and serve as a visiting professor. It is the first in the world created by Professor Isao Koshima outside Japan. “Lymphatic Surgery Center”.
The technical level of the expert team in finger reconstruction, lymphatic surgery, microscopic repair and reconstruction is in an international leading position.
Address: No. 11, Martyrs Shandong Road, Shandong Provincial Public Health Clinical Center, Baoshan District, West District, 3rd Floor, West Ward Building
Tel: 0531-67605731