Sunday, October 17

Accidents: How to act before an amputation, so that it can be fixed?



If we can boast of anything in Spain, it is to be a world reference in terms of organ transplants. The Spanish organ donation system is so oiled that even in full confinement, transplants continued to be performed. From March 13, the date of the announcement of the State of Alarm, until September 3, […]Read more…

If we can boast of anything in Spain is a world reference in terms of organ transplants. The Spanish organ donation system is so oiled that even in full confinement, transplants continued to be performed.

From March 13, the date of the announcement of the State of alarm, until September 3 they were held in our country 1,649 transplants from 760 donors.

But when we talk about transplants, although many are not aware, we are not only talking about organs such as the heart, liver or kidneys.

An accident in the workplace, a road accident or being the victim of a violent crime causes annual amputations in the upper or lower limbs.

These patients, about 250 a year, have to turn to specialists in plastic surgery for an intervention of reimplantation of limbs or revascularization, an intervention to restore blood flow in injuries with cut vessels.

There are also amputations caused by other causes such as burns, other accidents (domestic, trafficked) or tumors that, on exceptional occasions, are treated with composite tissue transplants, a field in which Spain has significant experience.

The Dra. Elena Ruiz, specialist in Plastic, Reconstructive and Aesthetic Surgery at Burgos University Hospital, explain what most of this type of transplants «are those of the upper limb, especially digital reimplantation and, fundamentally, thumb reimplantation ”.

Although other much less frequent interventions are also performed “such as those of the ear, scalp or penis”, explains Dr. Ruiz. In all cases, reconstructive surgery is key, since “amputation creates a disability in the patient, and this affects not only their usual work activity, but also their daily life.”

Usually workplace accidents are at the origin of this type of surgery. Specifically, according to the Ministry of Health, the approximate prevalence of these accidents is around five cases per million active population, so that in Spain there would be around 115 cases related to work accidents.

Rules to react quickly?

It is very likely that in our entire lives we will not have to face such a situation. But since knowing some basic sanitary procedures can get us out of more than one trouble, the Spanish Society of Plastic, Reconstructive and Aesthetic Surgery (SECPRE) offers some guidelines to promote reimplantation after an accident involving severed fingers, hands or arms.

Unfortunately there is some occasions when reimplantation of the amputated limb is not feasible. In these cases, composite tissue transplants, such as those of the hands or arms, are usually the alternative used by reconstructive plastic surgeons.

However, these are extraordinarily complex interventions that are only considered in exceptional cases, such as severe disability and dependency caused, for example, by double amputations.

Dr. Ruiz points out that these interventions “experienced a boom about 10 years ago, when several were performed in Spanish centers, but at present these procedures are not performed very frequently.”

The reason is “the need to associate a lifelong immunosuppressive treatment, with the side effects that this entails,” he explains.

In all cases, reimplants and tissue transplants, plastic repair surgeons must reconstruct very complex lesions in which bones and tendons as well as skin, nerves and blood vessels are affected, applying different surgical and microsurgical techniques, under the microscope, on all for the union of blood vessels.


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