14-hour surgery to re-attach seven severed fingers !!

In a gruelling 14-hour surgery from 6 p.m. on March 26 to 8 a.m. the following day, two teams of micro surgeons at Ganga Hospital here re-attached seven of the eight fingers of a 30-year-old man.Around 11 a.m. on March 26, Rajaram’s hands were caught in a paper cutting machine in a printing unit in Sivakasi.

The tip of the left thumb was sliced off. The other four fingers in the left hand were severed from the top edge of the palm. The index, middle and ring fingers of the right hand were also severed.

On the advice of a surgeon in Madurai, the severed fingers were packed properly and brought along with the patient to Ganga Hospital the same evening.Director of the Department of Hand, Plastic and Reconstructive Microsurgery at the hospital S. Rajasabapathy and Microsurgeon Hari Venkatramani performed the surgery. Dr. Rajasabapathy said in a press release that re-attaching the severed fingers was a long process. Normally, the surgery on each finger took three to four hours because the bone, tendons, blood vessels and nerves should be re-attached.

While the bones were fixed with thin stainless steel wires, the nerves and blood vessels were joined by small sutures that were one-twentieth of a millimetre in thickness.The entire surgery on both the hands was done under a microscope. While the tip of the left thumb could not be re-attached, all the others were put back in their place by the two teams of three micro-surgeons each and another team of three anaesthetists led by Ravindra Bhat.

They worked on the fingers for 14 hours continuously. The surgery was performed using local anaesthesia in the injured areas. The surgery involved joining 33 blood vessels (each 1 mm in diametre), 14 nerves, 14 tendons and seven bones.Each finger had at least four blood vessels (arteries and veins) of less than 1 mm in diameter.

Dr. Rajasapathy said the following steps should be taken to preserve the severed parts in order to make the re-attachment possible: The severed parts should be put in a plastic bag and tightly sealed with a knot.This bag must be put in a box or flask and ice cubes must be packed around it. Parts like fingers could be re-attached even after six or eight hours as these do not have muscle.

Those with muscle should be re-attached in two to three hours.

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