Mumbai
16 November 2018
DIVYA AZAD
Doctors at Bai Jerbai Wadia Hospital for Children(BJWHC), Parel performed an incredible feat of surgery to successfully repair and restore the hand function of an 8 year-old boy. Talha Umar Shaikh’s left hand was severely deformed and scarred after infection secondary to snake bite.
Talha, an 8-year-old boy from Nanded wanted to play with his toys, which were kept behind a cupboard. He was unaware of the big snake hiding behind their cupboard. As he put his hand behind cupboard to reach out to get his toy, the snake bit him. Immediately he was taken to local doctor, who treated him with anti-snake venom injection. After few days it was noticed that his left hand was swollen due to cellulitis and he developed a spreading infection. The local doctors suggested them that amputation is the only option; following which he was treated at a government hospital in Mumbai. The hand was saved, but the wound healing was delayed. No primary wound cover was provided and he developed a severe contracture and deformity of the left wrist and hand. His parents then brought him to BJWHC Parel, to see if his hand could be made functional.
Dr. Nilesh Satbhai, Plastic, Hand & Reconstructive Microsurgeon, at Bai Jerbai Wadia Hospital for Children said, “When the patient came to me, he 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.”
“The scarring was severe and extensive, which made surgery complicated. Our objective was to achieve full range of movement of the wrist and hand. The thickened scar over the left forearm and hand were excised. 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 the blood vessels in the forearm by microvascular technique using a microscope, 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.
Dr Minnie Bodhanwala CEO, Wadia Hospitals says, “The availability of microvascular skills, intensive care back-up and logistical requirements are the main limitations for such procedures. BJWHC is equipped with all the microvascular instruments and required infrastructure for such complex surgeries at a very low cost. We are glad that we’re able to perform this life changing surgery for Talha”.
Mahetab Shaikh, (father) says,” We are very thankful to doctors, nursing and support staff of the hospital as they have been extremely enthusiastic and helpful and they have saved our son’s hand. 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 the hand movements have started after physiotherapy.”
