SKIMS performs microvascular toe to hand transplant surgery

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In a first, Kashmir’s major tertiary care hospital, Sher-e-Kashmir Institution of Medical Science (SKIMS), achieved a rare feat after performing the “Microvascular Toe to Hand Transplant Surgery” to a 20-year-old youth successfully.

The surgery was performed by a team of microvascular surgeons of the department led by Dr. Mir Yasir (Consultant Plastic and Reconstructive Surgeon).

It took 12 hours to perform the highly specialised and skilled procedure to the Department of Plastic and Reconstructive Surgery of SKIMS to achieve a rare feat of “Microvascular Toe to Hand Transplant Surgery” successfully, a spokesperson of SKIMS said.

This surgery is technically very challenging, and even the slightest error can result in the loss of the reconstructed digit.

The surgery involves the 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 a high-resolution microscope (20 X) to the vessels and nerves of the hand using specialised microsurgical instruments to reconstruct a functional finger.

A successful surgery helps a patient 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.

The transplant surgery was performed at SKIMS on a 20-year-old male to reconstruct the index finger of his right hand using the second toe of his right foot.

The patient had suffered a machine injury that crushed all the fingers of his right hand except the thumb a year ago.

Only the little finger could be reimplanted and salvaged at the time of the initial trauma. The young boy was left with a crippled two-digit hand with a loss of the middle three fingers and thus could not perform any activity with his right hand.

While commenting on the surgery, Dr. 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 anaesthesia 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 procedure.

He also said that although microvascular surgery in the department started around two and a half decades ago, the department has progressed by leaps and bounds, doing complex and prolonged surgeries like complex tissue transplantations, 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 centres in North India and caters to a huge number of patients from all across the UT, being a pivotal referral centre. The department performs about 5,000 elective and emergency surgical procedures annually.

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