Successful thumb replantation at AIIMS Bhubaneswar

• Completely separated left Thumb replanted • Surgical procedure took 10 hours

• After discharge from hospital patient is doing fine

• First 6 hours after complete amputation is very important

Bhubaneswar: A clean-cut complete amputated left Thumb has been successfully replanted at AIIMS Bhubaneswar.

The surgical procedure headed by Associate Prof. Dr Sanjay Giri, Dept. of Burns and Plastic Surgery lasted for 10 hours. Post-operatively patient recovered well with a viable replanted thumb and has been discharged after 10 days, informed Dr. Giri.

This is for the first time AIIMS Bhubaneswar has performed such a successful thumb replantation. Rabindra Muduli(54) from Chandeswar, Khordha brought to AIIMS Bhubaneswar casualty on 20th April at 2AM with a machine cutter injury to the left thumb sustained at 9 PM (5hours back).

On examination patient had a clean-cut complete amputation of the left thumb at the level of the metacarpophalangeal joint (MCPJ). However, the amputated part was brought by the patient in a well-preserved condition. The patient was stabilized and planned for OT. Amputated part was preserved at low temperature. Patient was taken up for replantation of the left thumb at 9AM in the morning under regional anesthesia.

A team of surgeons was formed for the surgery comprising Dr. Sanjay Giri, Dr Santanu Suba, Dept of Burns & Plastic Surgery assisted by Dr Kaushik, Dr Ahana and Dr Gopika. In the Anesthesia team there were Dr Nitasha and Dr Pregmanshu.

To start the surgery amputated part was first prepared under the microscope with careful dissection of digital artery, vein, nerve tendons followed by preparation of the corresponding structures at the recipient site. And under the aid of the microscope each structure was replanted in a surgical procedure which took 10 hours, said Dr. Giri.

After surgery blood circulation in the joined thumb has been started. It means the replantation process has been successful. Gradually the thumb will start functioning with help of physiotherapy and other precautions, added Dr. Giri.

As per Dr. Giri in these cases first six hours is very important. When such incidents taking place then the amputate part has to be wrapped with a gauge piece or cloth piece and the same has to be kept in a polythene bag. Then the polythene bag should be kept properly in an ice chamber. The separated part should not be exposed directly to ice.