Patient N.V.H. K. (17 years old, residing in Thoi An ward, Ho Chi Minh City) was hospitalized after a workplace accident caused by a saw. Mr. K. shared: "This is my first day working as a carpenter and also the first time using a saw. Due to not being fully instructed on labor safety as well as how to operate the equipment, I had an accident during work.
After the accident, the patient was taken to a medical facility near the scene of the incident. Nearly 3 hours after the accident, the patient was transferred to Gia Dinh People's Hospital for further treatment.
After being transferred to Gia Dinh People's Hospital, it was recorded that the patient was in a state of complete blood loss in the 3rd, 4th and 5th fingers of the right hand. Recognizing this as an emergency microsurgery case, the hand surgery team was immediately mobilized to take the patient to the operating room.
MSc. Dr. Le Van Duong, Department of Traumatology and Orthopedics, Gia Dinh People's Hospital said: "According to the treatment team, the biggest challenge of the surgery is not finding the location of the severed artery but accurately identifying the surviving blood vessels to remove the entire crushed artery segment. After removing the damaged vessel segments, we decided to use venous segments taken from the back of the hand to replace all three fingers to restore circulation.
The surgery lasted nearly 10 hours continuously under surgical lenses and microsurgical microscopes. Doctors meticulously dissected each intact structure, identified blood vessel heads with a diameter of less than 1 mm and performed grafting with 9/0 microsurgical threads. This is a technique that requires very high accuracy because even a small deviation can affect the blood circulation of the finger.
After surgery, patients are closely monitored for bleeding their fingers every hour for many consecutive days to detect early complications of vascular obstruction if they occur.
The results after 48 hours showed that all three fingers maintained good circulation. After 2 weeks of monitoring, the fingers were completely alive, circulation was stable and passed the risk stage of revascularization surgery. This is a very encouraging result for a complex crushed injury case caused by a saw. Currently, the patient's condition is stable.
