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Manipal : The unit of Hand and Microsurgery, Department of Orthopaedic of Kasturba Hospital Manipal, led by unit head, Dr Anil K.Bhat, successfully performed a major replantation surgery on a 30-year old patient who came to the hospital with an amputated arm caused accidentally at his place of work. This is the first time that a surgery of this nature is being performed in Udupi district. It took all of three hours to complete the surgery.

The patient came around 12 noon on December 3, 2018. His arm was severed at the mid-arm level and the amputated part was in healthy condition as the accident had happened only one earlier. The patient’s relatives were told about the options including the possibility of replantation and its related risks.

With consent from them the patient was immediately shifted for emergency surgery and the replantation of arm was completed by the team of Orthopaedic surgeons Dr. Ashwath Acharya, Dr. Naveen Mathai and Dr. Siddarth Kamath under the guidance of Dr. Anil K. Bhat with anesthesia support from Dr. Manjunath Prabhu, Dr. Arun Kumar and Dr. Laxmi Shenoy. Comprehensive rehabilitation programme is being planned for him.

Major replantation represents surgical rejoining of amputated extremities from the level above the wrist joint. Success with major replantation are rare as these amputated parts have to be joined within the recommended time of six hours from the time of injury. Failure to join the limb within the “golden time” limit leads to subsequent death of muscles which cannot sustain lack of blood supply for more than three hours.

Usually if the amputated part is preserved in a plastic bag surrounded by ice, this time limit can be extended by another 3 to 4 hours. This was done in case of this patient immediately on arrival and the restoration of blood supply with fixation of bones and muscles was completed within the critical time limit.

The division of Hand and Microsurgery at the Department of Orthopaedics have been offering the services of replantation surgery successfully since the last 10 years. Dr Avinash Shetty, Medical Superintendent, Kasturba Hospital, Manipal congratulated the team lead by Dr Anil Bhat in performing the Surgery with high level of precision and said it gives more hopes to the Udupi and neighboring districts.