History of case regarding Traumatic Amputation:

Mr G 45yr male, by occupation contractor. On 1st August afternoon, he was attacked by somebody with sword and when he was trying to hold sword, his left hand was amputated at palm just distal to wrist. There was also bone deep cut at left side scalp and multiple incised wound face. He rushed to emergency department, actively bleeding from scalp and amputated stump soaked in blood with state of shock.

But they transported amputated part properly in ice bags. The resuscitation was started in casualty and he was shifted to operation theatre without wasting a single minute. In operation theatre our anaesthesia team stabilized patient hemodynamically by blood and volume expander and kept stable throughout surgery.

This complex Hand Replantation surgery took 8 hrs. During this surgery first bone was fixed, then flexor and extensor tendon were joined which help in finger movement. Then median and ulnar nerves repaired which give sensation to hand and finer muscles of hand. Then two major arteries (radial and ulnar) and four superficial veins repaired to establish blood circulation.

 

Patient kept in intensive observation, blood transfusion and dedicated nursing and perioperative care.

Now patient fingers are pink, warm and showing good circulation and patient is able to move his thumb and fingers.

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