Mumbai: Rare surgery saves boy's hand after snakebite
Eight-year-old's hand became deformed after bite; doctors at Wadia hospital perform microvascular op to save it
Doctors at the Bai Jerbai Wadia Hospital for Children have given a new lease on life to an 8-year-old, after a snake bite on his hand led to an infection and caused a deformity in it. But, doctors at the Wadia Hospital managed to save his hand with a rare microvascular surgery.
Snake bite causes infection
The boy, Talha Shaikh, was playing in his house in a village in Nanded, when he reached behind a cupboard to fetch a toy, when a snake bit him. He was immediately taken to a local doctor who treated him with an anti-venom injection. A few days later, it was noticed that the affected (left) hand was swollen due to cellulitis (a skin infection). When local doctors suggested an amputation, he was brought to a government hospital in Mumbai. The hand was saved here, but it did not heal. No primary wound cover was provided and he developed a severe contracture and deformity in the left wrist and hand. His parents then took him to the Wadia Hospital at Parel, to see if his hand could function again.
Skin and soft tissue from the left thigh were connected to the forearm
Microvascular surgery planned
Dr Nilesh Satbhai, Plastic, Hand and Reconstructive Microsurgeon at the hospital, performed a rare microvascular surgery on Talha's hand. It is extremely complex and uncommon
among children. "The patient was unable to perform any useful activities with his deformed left hand. The severe skin and muscle necrosis on the dorsal aspect of the left hand and forearm had resulted in gross functional and cosmetic deformity. We planned a surgery to correct the deformity, release the contracture and resurface the defect with a microvascular free tissue transfer. Microvascular surgery in children is complex and relatively uncommon. Hence, it is only being performed at well-equipped tertiary care centres." Mahetab Shaikh, father of Talha said, "When we brought him here his left hand was completely deformed, he could not hold any object or make a fist. But now the wounds have healed and he can make hand movements after physiotherapy."
'Risk was high'
Doctors said the scarring was severe and extensive, which made surgery complicated. "The stiffness and contracture of the left wrist and hand were released and complete range of movement achieved. A flap consisting of skin and soft tissue from the left thigh was harvested. The blood vessels of the flap were connected to those in the forearm by microvascular technique, to re-establish the blood supply to the flap. The musculotoxic venom of the snake had also caused some scarring of the tissues and blood vessels. Hence the technical challenge and risk involved in this case was higher than usual," added Dr Satbhai.
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