Media Release

Mangaluru, Jun 11: A challenging and rare surgery involving the rejoining of four amputated fingers has been successfully performed by the plastic surgery department of AJ Hospital.

Sandeep aged 28 years sustained accidental trauma to the left hand while working in Padubidri resulting in amputation of all four fingers. They were subsequently rejoined successfully by microvascular surgery, which lasted six hours.

The microvascular surgery was conducted by head of plastic surgery dept Dr Dinesh Kadam along with Dr Sanath Bhandary, Dr Rajesh Hukkeri and anaesthetist Dr Trivikram Tantry.

Hand injuries continue to dominate workplace accidents and amputations result in severe incapacitation and disability in young men. In this rare injury, all four fingers were completely separated from the hand, which were restored successfully by microvascular surgery.

The successful re-plantation or rejoining of amputated parts requires repair of all structures including bone, tendons, nerves, blood vessels and skin. Most important critical step in this procedure is the restoration of blood circulation in each of the fingers with repair of multiple tiny blood vessels under high magnification operative microscope. Equally important is continuous post operative monitoring of blood circulation in these fingers. Once the survival of rejoined fingers is ascertained, gradual and sustained physiotherapy is started to restore the finger motion and optimal functional results.

The successful outcome depends on many variables like; type of injury (crush or clean amputation), timing of injury, mode of preservation while transport, availability of expertise and technical difficulties during surgery. The procedure itself takes several hours to perform under the operative microscope.

It is crucial that the amputated parts are to be transported in a clean polythene bag which is sealed tightly and placed in a container with ice containing water. The parts should not be in direct contact with ice or water.

The department of plastic surgery established 12 years ago under prof Dinesh Kadam has performed over 12,000 plastic surgical procedures including cosmetic, reconstructive and microvascular surgeries. It is the first department in Mangaluru to start super-speciality – MCh course (after MS degree) recognized by Medical Council of India. The dept also provides free surgical treatment for children with cleft lip and palate deformity in collaboration with The Smile Train.

The appropriate and timely transfer to the hospitals with such facility is invaluable for injured victims to avert a life-long disability and psycho- socio- economic consequences.