Surgeons of the Central Medical and Sanitary Unit of Magnitogorsk sewed a brush to an employee of a large industrial enterprise, torn off by a loader frame. The victim himself says that he did not even hope to save the limb, however, two months after the operation, he can already take a pen in his hand and even do some household chores at home.
“Everything is in a hurry, haste,” admits foreman Fyodor Kochukov. - I control the loading and unloading, and this evening I was in a hurry - my hand slipped, it was caught by the frame and was torn off. I saw the injury myself, so when I went to the hospital I was 100% sure that everything …"
However, the doctors of the medical unit decided to fight for the brush. “It was August 26, the end of the week, Friday, everyone left. I was also in the garden with my family, - recalls the head of the operating unit, cardiovascular surgeon of the Central Medical Unit, Dmitry Kovalchuk. “Late in the evening, the surgeon on duty, Yevgeny Efimov, called me and said that a young man from production had been admitted with a serious injury - he wanted to consult, maybe it’s still possible to do something.”
Dmitry Kovalchuk, Head of the Operating Unit, Cardiovascular Surgeon, Central Medical Unit of Magnitogorsk
The injury occurred almost at 10 pm, so the time, indeed, was late, however, despite this, the manager was already in the operation block 15 minutes later. What he saw was not encouraging. “Rama completely tore off the joint, the hand was hanging on the flexor tendons and nerves, many of the extensor tendons of the fingers were torn out. It was a massive wound and very heavily soiled. There was a lot of industrial dust in its place, so the hand was all black, and this is a very high risk of purulent complications,”explains Dmitry Yegorovich.
However, it was impossible to hesitate: the longer the hand remained without blood flow, the faster the chance of salvation melted. The joint was shattered, so the surgeons called an experienced traumatologist Mikhail Marikin to help them, and they themselves began to wash the wound.
“When I arrived, the patient was already in the operating room and was anesthetized. We started by taking a basin of water, household soap, immersed the wound in this basin, washed everything and only then decided what we have,”says the doctor. - Considering that the median nerve was preserved and the radial and ulnar nerves were partially wounded, we strengthened our thoughts about saving the limb. After that, they began to sew arteries and veins in order to restore blood circulation in the hand as soon as possible. A total of about two hours passed from the moment of injury to the start of blood flow. We sutured two arteries, two saphenous veins, after which the traumatologists proceeded to their stage of joint formation”.
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Excellent work of the Magnitogorsk surgeons - the hand is saved, and the functions are slowly restored during rehabilitation
Part of the bones of the wrist joint were crushed during the injury, and they could not be left, but the traumatologists collected everything they could, then they sewed the joint capsule and proceeded to suture the tendons. Some of them could not be saved either, so all the remaining extensor tendons of the fingers on the hand were sewn to one that remained on the forearm, and then the integrity of the skin was restored.
For more than four hours, the surgeons conjured over the severed hand, but as a result, their efforts were crowned with success. Within a day, the patient was transferred from the intensive care unit to the ward, he felt rather well, only the hand was still swollen and bluish - a consequence of ischemia.
Doctors note that the first week has become decisive for the engraftment of the hand. “She was the most tense,” says Dmitry Kovalchuk. "The patient received strong drugs aimed at improving microcirculation, very strong antibiotics, because sepsis could develop instantly." However, after a week, the swelling began to subside and the brush began to show the first signs of life, only then the surgeons sighed - the worst was over.
Alexander Yatluk, head of the surgical department of the polyclinic №2 of the Central Medical Hospital
Now doctors have almost no fears that Fyodor Kochukov will remain disabled. “All the stitches have been removed, the dressings have already been completed, now we have to deal with the restoration of hand functions,” says Alexander Yatluk, head of the surgical department of the polyclinic №2 of the Central Medical Hospital. - Until it is fully restored, the patient can bend the fingers and even hold the handle, although this is the left hand, but cannot fully extend them. The rehabilitation process in such cases is always long, in the near future we plan to send the patient to the rehabilitation department, where he will undergo a course of rehabilitation treatment."
However, already now Fyodor Kochukov has begun to do something around the house. “I can screw and unscrew something already, nail a nail with my right hand too - hold it with my left,” he notes. - I am still on sick leave, but I hope I will manage without disability and I will be able to return to work. Thank you very much to the doctors, they are actually doctors from God!"
A hand sewn in in August is far from the first operation to save severed limbs in a medical unit. Surgeons recall how a couple of years ago an injured person was admitted to them with a torn off leg up to the hip. Now the man walks on his limb sewn by surgeons, and there are no fears about his health.
“Such operations are very rare, and in order for them to be completed successfully, all conditions must be met: the fastest possible delivery of the patient, the availability of equipment, microsurgical instruments, high-quality suture material in the hospital, and, of course, the willingness of the team to perform complex reconstruction, and not planned, but emergency, like this one,”concluded Dmitry Kovalchuk.
Svetlana Talipova