Microsurgery and Reimplantation
Reimplantation is a procedure in which completely divided part of the body was can be put back surgery. It is a super major surgery which takes 8 to 10 hrs or more than that depending on a number of fingers being reimplanted. In this procedure completely divided hand, fingers can be reimplanted. During surgery first divided part was dissected under microscope to locate tiny arteries and veins. During surgery divided bone, extensor tendon, flexor tendons, nerves, arteries, veins and skin were repaired.
Arteries and veins are repaired under the microscope with very fine sutures which is finer than hair. We have Carl Zeiss Vario Microscope under which we can repair arteries and veins which are less than 1 mm diameter.
Case operated at our hand surgery center:
13 yr boy had the traumatic amputation of right hand while working on grass cutting machine. Reimplantation was done.
Before Surgery
During Surgery
After Surgery
Guideline for Reimplantation:
Method of storing reimplanted part- It has to keep in the plastic bag which is tightly packed. This plastic bag should be kept in the container having ice cubes. The timing of reaching to the hospital- Patient has to reach as early as possible because the divided part is lack of blood circulation and it stays viable for very few hours.
The patient should reach to the hospital within first 6 hours of injury. Since fingers are lack of muscle tissue in case of finger level amputation reimplantation can be done up to 12 hr. provided part should be well preserved.
In which cases reimplantation cannot be done?
If general condition of patient is critical, life saving is preferred over reimplantation. Crushed divided part, multi level amputations can not be reimplanted.