How reattaching limbs works
By Marshall Brain
http://www.JewishWorldReview.com | (MCT) This year there have been two cases where an alligator ripped the arm off a man. The first case, in April, got wide publicity because of a huge photo in Popular Science magazine.
What the photo showed was an alligator at a Taipei zoo standing there with the guy's arm in his mouth. Then in September the same thing happened again in South Carolina. This time the alligator swallowed the arm, but after killing the gator they were able to retrieve the limb.
In both cases, doctors tried to reattach the arms. And this raises the obvious question: If you were to one day see a person lose his or her arm, would you know what to do? Or what about something more common like a finger? People are losing fingers all the time to things like table saws and hedge trimmers. If your neighbor happened to lose one of his, would you know how to handle the situation?
This is an important question because the art and science of replantation gets better every year. Surgeons are having more and more success reattaching things like arms and fingers. But for replantation to have a chance, you need to act fast. There are three things you should think about: 1) saving the patient; 2) saving time; and 3) saving the limb.
Obviously, saving the patient is the most important thing. This means that you need to get the patient out of danger and stop the bleeding. You can use a cloth or towel and apply pressure to get the bleeding under control. In the case of an arm, you can also apply pressure with your fingers to the artery in the underarm area and cut off arterial blood flow that way.
To save time, you need to call 911 immediately. Calling 911 is important for two reasons. First, you will need all the help you can get stabilizing the patient and transporting him. But you also want to report the severed limb. Reattaching a limb is a complex process and time is of the essence, so the hospital can assemble a team.
And then we come to the limb itself. To save it, you need to stabilize it too. You need to keep it moist and cool it down. The recommended procedure is to wrap the digit or limb in wet paper towels, then wrap it in plastic, and then pack it in ice. You don't want ice to directly touch the limb because that can cause frostbite.
Once the patient and the body part gets to the hospital, the miracle of science can take over. An orthopedic surgeon will normally do the operation. Reattaching a limb is obviously complex, but the basic steps are easy to understand.
The first thing is the bone. Usually it is shortened a little and cleaned up. Then the bone ends are wired or pinned together. Next come any of the tendons and/or muscles that were cut. Then the arteries, veins and nerve endings can be sewn back together. And finally the skin. Doctors can use skin from other parts of the body to cover the damaged area.
After the whole thing heals, it won't be perfect. And some additional surgery may be required. It would be unreasonable to expect that after such trauma, the limb will come back 100 percent. But patients often get half or more of the limb's functionality back. Children usually have a better prognosis because their still-growing nerves have a good chance of knitting back together. And physical therapy can help with range of motion, flexibility and muscle control.
Now, in this kind of emergency, you'll know what to do. Remember: save the patient, save time and save the limb.
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