India Surgeon Rejoins Severed Hand

From the Times of India comes yet another story of orthopedic prowess. Micro surgeon Birendra Kishore Sharma, M.D., of Deepak Hospital, reattached the completely severed right wrist of 25 year old Rakesh Pandey. A local farmer, Pandey lost his hand when it became stuck in a part of a fodder-cutting machine he was operating.

When he was contacted, Sharma told Pandey’s relatives to keep the severed wrist in a plastic bag in an airtight and watertight container, keep it on ice and bring it, along with Pandey to the hospital as soon as possible.

The patient and severed hand did not reach the hospital until about 6:30 p.m. Surgery began immediately and continued until 2:30 in the morning. Sharma noted that the success rate of such operations is only 80% and depends on a number of factors—age of the patient, type of amputation, time of reaching the plastic surgeon, and skill of the surgeon. “The margin of error is very small and errors made technically cannot be erased chemically, ” he said.

“Surgery on the severed wrist was started with separation and identification of tendons, nerves, arteries and veins, ” he explained. “After fixing of bones, first tendons, then nerves and then arteries and veins were joined. The next two-three days were very crucial as there was risk of veins and arteries getting blocked again, which could have necessitated re-surgery”. Sharma said that since 1992, he has saved hundreds of hands, including about two dozen cases of completely severed hands. With physiotherapy, it can take months for the hand to start functioning again, he said.

Sharma underlined the importance of government-run trauma centers to handle cases of replantation and revascularization. “After the brain, the hand is the most important organ for earning a livelihood. Most serious hand injuries are caused to working class people and, therefore, the government should work in this field, ” he said.