This is Your Brain On Awesome Thoughts on the world from a student of the mind

21Nov/10

Limb reattachment is awesome as well!

So a few of you might have remembered a post that I recently had on the new Berkeley Science Review blog in which I described a thoroughly amazing surgical procedure known as "Rotationplasty."  Well, I may have found another bit of medical ingenuity that's almost as cool

Now, when I mention the phrase "limb reattachment," you might think that this is an incredibly complicated procedure already, and you'd be right.  Unsurprisingly, appendages were not designed by nature to be easily replaceable or reattachable, and fitting one back to the right location is truly a feat of technology (and patience)!

Firstly, when a limb is lost, there is precious little time to get it back to its owner.  All of our bodily tissues are in constant motion, metabolizing and using energy.  When a limb is lost, this machinery keeps moving, but the energy that is normally supplied by your bloodflow is cut off.  This means that in order for a limb reattachment to be successful, you need to restore bloodflow to the isolated body part before its own metabolism "runs out of fuel" and dies.

(At the risk of tangenting a bit, there's another fascinating piece of medical lore I found out about with regards to this.  Apparently, if you're worried that the cut off limb won't have enough time before you can reattach it, doctors have been known to use leeches to start sucking the blood out of the exposed veins in the appendage.  Leeches, bloodsucking creatures that they are, excrete a special kind of chemical as they do their business which prevents the blog from coagulating, thus expanding the lifespan of the separated limb.  Here's a great article in Slate that covers limb reattachment in general.)

Anyways, assuming that you do make it to the operating room in time, doctors need to re-hook-up the veins, arteries, and nerves in a very specific manner.  It's a very delicate process, and requires literally matching up these bits of plumbing one at a time.  Unfortunately, it also means that the tissue on either side of the cut needs to be relatively healthy, something that brings me to the present story.

Meet Ming Li, a young Chinese girl who lost her entire hand in a terrible farming accident.  Upon arriving at the hospital, doctors found that her arm was far too damaged to be able to reattach the hand to her arm.  Unfortunately, they also knew that leaving it unattached for more than a day or so would result in permanent loss of the hand.  So what did they do?

That's right, they attached the hand to her foot to allow time for the hand to heal.  Remember, the most important thing for a lost appendage is that blood starts flowing back to it, allowing the nutrients in the bloodstream to give it fuel to keep functioning.  By attaching the hand to the girl's leg, they allowed it time to stay alive, and once the arm had been properly healed, they cut off the hand and reattached it to her wrist.

She's now slowly regaining the use of her hand, which will likely lose quite a bit of its previous movement and feeling.  However, the fact that she's got one at all blows my mind...what an impressive operation!

via Orange

(and thanks to Samantha Neal for giving me the scoop!)

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