The fingers of the hand of the re-implanted limb began to move again and the doctors resolved the prognosis for the 74-year-old man from the province of Brindisi, who arrived at the Bari Polyclinic on March 26 with a completely amputated arm after an accident with a chainsaw :
An emergency surgical operation lasting more than six hours and the intervention of two teams, that of reconstructive and aesthetic plastic surgery, directed by prof. Giuseppe Giudice , together with that of orthopedics and traumatology, directed by prof. Biagio Moretti .
The multidisciplinary team worked simultaneously on the amputated piece at the level of the proximal III and at the level of the stump to be prepared for reimplantation, assisted by anesthesiologists and highly specialized nursing staff. First the evaluation of the patient was carried out, stabilized and intubated at the Perrino hospital in Brindisi, where he had arrived at the end of his life due to the important haemorrhage following the trauma. Then there was the removal of numerous foreign bodies(grass, stones, earth) which could have led to a subsequent infection:
Once all the injured anatomical structures were prepared by the plastic surgeons, the orthopedic surgeons led by dr. Massimiliano Carrozzo with Dr. Floriana Palmiotto , performed bone synthesis of the radius and ulna with internal and external synthesis means. At this point the plastic surgery team, led by prof. Michele Maruccia with Dr. Caterina Angelini and Dr. Alessio DeCosmo, completed the reconnection of all the flexor and extensor tendon and muscle anatomical structures, as well as the microsurgical reconstruction, through the use of the microscope, of the arteries, veins and nervous structures thus obtaining the complete reimplantation of the amputated forearm. All assisted by the anesthetists Ilaria Di Giglio and Angela di Ciaula .
“The microsurgery team, available 24 hours a day, seven days a week, is an excellence for our Polyclinic. The collaboration with the team of prof. Moretti represents the maximum expression of the concept of ‘orthoplasty’, which provides for the collaboration of the two specialties in order to obtain the maximum functional results in patients with severe trauma to the limbs as in this case” , explains Prof. Giudice .
After the operation, the man was hospitalized for about a week, subjected to continuous checks on the vitality of the limb. Then he was discharged in good clinical condition and able to partially move the fingers of the hand of the re-implanted limb. He has embarked on an assisted rehabilitation process and complete neuromuscular regeneration will take place no earlier than 18 months, then he will be able to return to most manual activities.
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