SKIMS Performs Microvascular Toe to Hand Transplant Surgery

Srinagar: Department of Plastic and Reconstructive surgery, SKIMS achieved a rare feat after performing its first “Microvascular Toe to Hand Transplant Surgery” successfully.

The highly specialised and skilled procedure lasted about 12 hours. This surgery is technically very challenging and even the minutest of error can result in loss of the reconstructed digit. The surgery involves removal of a toe from the foot along with its microvasculature (arteries and veins for blood supply), nerves (for sensation) and tendons (for movement) and transplanting the toe to the nonfunctional hand with deficient digits to make it functional.  After stable bony fixation, the vessels and nerves from the toe are then anastomosed (microvascular anastomosis) under high resolution microscope (20 X) to the vessels and nerves of hand using specialized microsurgical instruments to reconstruct a functional finger. A successful surgery helps a patient to carry out daily activities like eating, gripping, lifting and other vital functions performed by the hand. At the same time the donor foot does not suffer from any functional impairment and the patient can walk normally.

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The transplant surgery was performed at SKIMS on a 20year old male to reconstruct the index finger of his right hand using the second toe of his right foot.  The patient had suffered machine injury which crushed all the fingers of his right hand except the thumb a year back.  Only the little finger could be reimplanted and salvaged at the time of initial trauma. The young boy was left with a crippled two-digit hand with loss of middle three fingers and thus could not perform any activity with his right hand.

The surgery was performed by a team of microvascular surgeons of the department led by Dr. Mir Yasir (Consultant Plastic and Reconstructive Surgeon). While commenting on the surgery, Dr Mir Yasir expressed his satisfaction over the fact that the patient would be able to use his hand for daily activities. He further added that SKIMS offers a platform for such surgeries owing to high end equipment, proper training, dedicated anesthesia care and diligent theatre staff.

Prof. Adil Hafeez Wani, Head of the department, Plastic and Reconstructive Surgery, SKIMS, while expressing his happiness said that only a few top notch centres in major cities of the country are performing this kind of a procedure. He also said that although microvascular surgery in the department started around two and a half decades back, the department has progressed leaps and bounds doing complex and prolonged surgeries like complex tissue transplants, brachial plexus injuries, hand and finger re-implantations etc.

It is pertinent to mention that the department of Plastic and Reconstructive Surgery, SKIMS is one of the leading plastic surgery centers of North India and caters to a huge number of patients from all across the UT, being a pivotal referral centre. The department performs about 5000 elective and emergency surgical procedures annually.

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