Two weeks ago, a young man was wheeled into Kenya's top referral Kenyatta National Hospital’s Accident and Emergency room writhing in pain.
The 17-year-old Joseph Theuri’s right hand was severed at the wrist while cleaning a chaff cutter used for cutting straw or hay for farm animals.
Since similar accidents are commonplace among residents of Kiambu in central Kenya where he comes from, no one imagined he could be made whole again.
As it is, many Kenyans believe that it is almost impossible to re-attach an amputated limb, and even if it can be done, it is a costly procedure out of reach for many.
Most accidental amputations are messy affairs, resulting in crushed limbs or other serious injuries that can sometimes make such complicated procedures as re-attachment impossible.
However, in cases such a Theuri’s, where the amputation was a clean cut, doctors say limbs can be re-implanted onto the severed part of the body.
This is what happened on the evening of January 26, when Theuri underwent a seven-hour procedure at KNH to re-attach his hand.
A team of 15 plastic and orthopaedic surgeons, anaesthetists and nurses successfully carried out the procedure, which begun at 10pm and ended at 6am the following day.
“I only realised my hand was missing when I saw a pool of blood in the cloth I was using to clean the machine,” he remembers, saying he accidentally switched on the machine when he was cleaning it.
Theuri’s sister wrapped the amputated hand in a plastic bag and rushed him to Kiambu Hospital where the doctors sanitised it and put it in a cooler box.
They also worked to stop the excessive bleeding before evacuating him to the referral hospital in Nairobi.
Once there the team of specialists worked overnight in two teams to re-attach the hand.
“We started the procedure immediately, working to attach the nerves, tendons and blood vessels. We also needed to align the bones,” one of the lead surgeons, Dr Nang’ole Wanjala, who led the procedure with the company of the University of Nairobi’s Prof Stanley Khainga overseeing the whole procedure, said.
To save on time, Dr Nang'ole said one team worked on preparing the detached hand with the other on the stump of the forearm.
Preserving the hand in a cooler box helped to keep it alive, the doctor said.
According to the doctors, Theuri is likely to recover between 80 and 90 per cent of the functions of the hand.
“Already, we can see the blood flowing back in his hand. We determined this by pricking his thumb and seeing the blood flow,” Prof Khainga said.
Theuri's hand was replanted within 12 hours of the accident.
Replantation is the surgical re-attachment of a finger, hand or arm that has been detached from the body.
Key to replantation is the time between the injury and surgery.
“We aim to have the surgery done within 24 hours of the injury but in the event that is not possible, we still give it a try. As soon as the accident happens, try and get hold of a cooler box to put the limb,” Dr Nang’ole explained.
“This successful surgery adds into the list of the great milestones that KNH specialists have achieved to save, transform, reclaim and prolong lives of many Kenyans and patients from East and Central Africa,” KNH’s CEO Lily Koros said.
What to do when body parts fall off
- The first thing to do when a body part becomes detached is to control the bleeding. Put direct pressure on the wound and elevate it higher than the heart, advises Dr Nang’ole.
- Then rinse off the severed part to decrease the risk of infection, but do not scrub.
- Dampen a clean cloth or piece of sterile gauze with cold water and wrap the limb before placing it in a plastic bag.
- To keep the cells of the detached limb alive, place the bag in cold (preferably iced) water. However do not put the part directly in ice, experts say.