Selayang Hospital Records Three Successes In Reattaching Two Severed Hands

By Yasmin Ahmad Zukiman

KUALA LUMPUR, Oct 21 (Bernama) -- The Selayang Hospital’s success in reattaching both hands of patients in three cases over an 18-year period demonstrates its expertise in handling complex surgeries that are very rarely performed even in major medical centres worldwide.

Its Hand and Microsurgery Department head, Datuk Dr. Rashdeen Fazwi Muhammad Nawawi, said that the successes reflects his team's capability in performing high-risk surgeries that require specialised expertise, meticulous coordination, and swift action to save the patient's limbs.

"Hand injuries or amputations usually occur on one limb only, and in medical literature as well as in major medical centres around the world, the reattachment of both severed hands occurred two or three times in 30 years.

"However, at Selayang Hospital, the situation is different because we have performed hand reattachment surgeries with three cases recorded over 18 years," he told Bernama.

He said the latest case about two months ago involved a Malaysian man in his 30s who had an accident at work when both of his hands were severed at the wrists by a wood-cutting machine.

Dr. Rashdeen Fazwi said the reattachment surgery of both the patient's hands was successfully performed in about six hours, with two surgical teams handling each hand simultaneously to avoid delays that could jeopardise tissue viability.

"The patient is now at home and will be readmitted to the hospital for rehabilitation, and hand function is expected to recover around 70 to 80 per cent, depending on the progress of recovery and the patient's effort," he said.

According to him, the surgery requires the involvement of an emergency team to stabilise the patient before being taken to the operating room, five hand surgery consultants including himself, four orthopaedic specialists undergoing sub-specialty training, six to eight medical officers, three to four medical assistants, and approximately 27 nurses.

He said the success of a surgery depends on careful monitoring after the procedure to detect complications that may occur even if the hand or finger shows signs of still being alive.

"The success of reattaching a severed limb is also influenced by several factors including the patient's age, the severity of the injury, the condition of the severed limb, and the duration between the incident and the patient receiving treatment, which can determine the chances of the limb being reattached and functioning well," he said.

Dr. Rashdeen Fazwi, who has had experience in the field of hand and microsurgery since 2008, said the process of reattaching severed limbs involves three main phases: pre-surgery preparation, the surgical procedure, and post-surgery monitoring and rehabilitation.

"As soon as a case is received, the hand surgery team will communicate with the referring hospital, the emergency department, and the anaesthetist to coordinate actions and ensure the patient is stable before being taken to the operating room.

"The replantation or reattachment process requires high precision because each structure of the hand needs to be repaired one by one, including bones, blood vessels, nerves and tendons, using micro-surgical techniques and fine sutures before the skin is closed," he said.

He said the department, which has been operating since 2000, is a hand surgery centre with the largest team in the country and serves as a training centre for hand expertise and microsurgery for the Ministry of Health (MOH).

The department is also managed by four consultants, fellows, and doctors in postgraduate training in orthopaedic and plastic surgery who handle complex emergency trauma cases as well as elective hand and micro surgeries.

"Since 2021, the Hand and Microsurgery Department has handled 155 cases of limb replantation, while the number of other complex surgeries performed each year ranges from 450 to 500 cases.

"Among the treatments provided are brachial plexus nerve injuries, congenital hand deformities, tumours and cancer in the hand, sports injuries, nerve entrapments such as carpal tunnel syndrome, and joint damage requiring joint replacement surgery, hand injuries due to accidents, tendon and nerve injuries," he also said.

Meanwhile, Dr. Rashdeen Fazwi advises the public to prioritise their own safety and the life of the victim in the event of an accident resulting in a severed limb, and to seek emergency assistance immediately.

He added that the severed limb should be wrapped in a clean, damp cloth, placed inside a sealed plastic bag, and kept cool using ice water. However, it must not be placed directly on ice, as this could cause tissue damage that might compromise the chances of the limb being successfully reattached.

-- BERNAMA