Around 5 pm on February 20, Chengdu BOE Hospital admitted a male patient who accidentally sawed off 4 fingers on his left hand while using a chainsaw. Doctors found that except for the thumb, the man’s remaining four fingers were completely severed from the metacarpophalangeal joint.
The golden replantation time for severed fingers is 6 to 8 hours. The earlier the operation is performed, the greater the chance of successful replantation. In a race against time, the hospital opened the green channel, completed preoperative preparations in half an hour, and the injured were pushed into the operating room. From 6:00 p.m. on the 20th to 6:00 a.m. on the 21st, after 12 consecutive hours of emergency surgery, the replantation and reconstruction were finally successfully completed. Now, the injured are in stable condition.
↑The doctor checks the recovery of the injured after surgery
Accidental
4 fingers were accidentally cut off while using a chainsaw
At nearly 5 p.m. on February 20, Zhao Tao, an orthopedic doctor at Chengdu BOE Hospital, received a call from the emergency department saying that an injured person who had four fingers completely amputated by an accident needed treatment. Zhao Tao rushed to the emergency department and saw that a male patient’s left hand was completely amputated except for the thumb, and the other four fingers were completely severed, and the severed fingers were taken to the hospital together in a plastic bag.
It turned out that the injured man accidentally cut off 4 fingers on his left hand by a sharp saw blade while using a chainsaw.
Replanting a severed finger requires time. Yuan Chongxi, an orthopaedic surgeon who was the chief surgeon for the injured, explained that after severed limbs, especially large limbs, the prime time for replantation is required, usually 6 to 8 hours. However, The larger the amputated limb tissue, the greater the oxygen consumption, and the shorter the time required for reconstruction and replantation. So replant as soon as possible, the better the chance of survival.
An emergency surgery in a race against time begins immediately through the green channel. “The injured person first had blood routine, coagulation function and electrocardiogram and other necessary examinations in the emergency room, and entered the operating room within half an hour.” Zhao Tao said.
Surgery
Suture vessels, nerves, etc. one by one for 12 hours
strong>
At 6 p.m. on the 20th, the injured were pushed into the operating room. The operating team was divided into two groups. The chief surgeon Yuan Chongxi, the chief surgeon, performed debridement of the isolated stump, and dealt with the broken palm and phalanx. Each blood vessel, nerve, and tendon was marked, and a team of physician Zhao Tao cleaned the broken ends and found the blood vessels, nerves, and tendons that could be replanted one by one. After each treatment was completed, the two groups tacitly matched the severed palms, repaired the frame, fixed the bone ends, and anastomosed the arterial and venous blood vessels.
Yuan Chongxi said that vascular reconstruction is a delicate task. Under the microscope, the blood vessels, nerves, tendons, etc. are sutured one by one with sutures that are not much thicker than a human hair. Especially venous blood vessels are not only tiny, but also thin, brittle, inelastic, and difficult to suture. The operation time, from 6:00 pm on the 20th, continued until 6:00 am on the 21st.
The operation went well, and the injured 4 fingers recovered.
Postoperative
Strictly lying down for 7 to 14 days Follow-up rehabilitation training
According to reports, postoperative management cannot be taken lightly. Yuan Chongxi said that during the recovery period, the most worrying thing is the embolism of veins and arteries, which will reduce the survival rate. Therefore, every hour, the medical staff must check the color, temperature, tension, etc. of the injured person’s fingers, and clean and replace them regularly. Medicine. And smoking, mood swings, wound pain, these seemingly inconspicuous details are also related to the survival of severed fingers.
“48 hours after the operation, the microcirculation reconstruction of blood vessels begins.” Yuan Chongxi said that the tiny blood vessels begin to “grow” and become thicker and thicker. After the new blood vessels are stabilized, a stable blood circulation can be established. . For the next 7 to 14 days, the injured will need to lie on their backs strictly to keep blood circulation stable.
On the 24th, the third day after the operation, the injured person recovered well. Yuan Chongxi said that following smooth recovery and rehabilitation training, at least 80 to 90% of the injured person’s left hand function can be restored, which will not affect daily life.
【Science Tips】
< p>In case of amputation, in addition to bandaging to stop bleeding
The amputated limb (finger) should be refrigerated immediately
In work life, accidents happen occasionally. In the event of a limb amputation accident, how to deal with it correctly can it bring favorable results to the follow-up treatment? Yuan Chongxi said that in the event of an accidental amputation injury, if conditions permit, a clean tourniquet should be used to stop the bleeding immediately. Refrigerate in a container with ice cubes and take the injured to the hospital.
Yuan Chongxi reminded that the severed (finger) limbs must not be placed directly on ice for freezing, let alone immersed in hot water or other liquids. These are not conducive to the later replantation surgery. May affect survival rate.
Red Star News reporter Yu Zunsu Intern Liao Binghua Tuju Hospital
Editor Yu Mange