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An on-call plastic surgeon working at Sheikh Khalifa Medical City (SKMC) has successfully saved a man’s badly damaged hand by operating on him in the nick of time. The patient, who had presented at the hospital’s Emergency Department (ED), was not only minutes away from having his left hand amputated, he was also in danger of losing his life such was the extent of the blood loss from his injury.
Dr. Hussam Al Din Musa, a Consultant Plastic Surgeon, was the physician at the heart of the crisis. The doctor was spending his fifth day on call at SKMC when the gentleman concerned presented with deep lacerations to his forearm. The catastrophic injury had been sustained when he had been running to meet a friend and slipped, putting his hand through a sharp metal grating, resulting in gashes that tore his ulnar and radial arteries. The ruptures led to a large volume of blood being lost - blood that should have been circulating around his body and supplying essential oxygen to his hand.
“Once the patient’s life had been saved and his condition stabilised in ED by prevention of the bleeding, the next most important thing was to try and save his hand, as muscle and nerve tissue can only survive for two hours without a blood supply,” said Dr. Hussum, speaking from his clinic yesterday. “The gentleman had already bled significantly before getting to ED, so time was of the essence. Fortunately, with the whole ED and Operating Room (OR) team working together, we were able to get him to surgery in about half an hour,” he added.
The first priority for Dr. Hussam was to ensure that one of the arteries was repaired immediately, which would ensure that the hand was adequately perfused. This would buy sufficient time for the extensive procedure that lay ahead, as in addition to the bi-lateral artery repair, Dr. Hussum had to perform complex surgery on 11 severed tendons and a damaged nerve in the patient’s arm.
Fortunately for the patient, Dr. Hussam, who has been working at SKMC for nearly nine years, is highly trained in the precise and delicate nature of the surgery required, having obtained a specialist qualification in microsurgery. The discipline involves working to reattached severed blood vessels and damaged nerves using a microscope.
Following several hours in the OR, the patient is now doing well on a surgical ward at SKMC and has passed the critical three-day post-operative period. Although he is experiencing some sensation loss, it is hoped that he will regain full function in his left hand. He is due to be discharged within the week.
“Thankfully the patient is now recovering well and is over the 72-hour period where complications from the surgery are most likely to occur,” said Dr. Hussam. “He has now started to move his fingers and with extensive physiotherapy he should have regained all feeling and use of his hand in six-nine months,” he added.
SKMC is part of the SEHA Health System and is owned and operated by Abu Dhabi Health Services Company PJSC (SEHA), which is responsible for the curative activities of all the public hospitals and clinics in the Emirate of Abu Dhabi.
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