According to Dr. Tran Phuoc Binh - Department of Orthopedic Trauma, Cho Ray Hospital, Ho Chi Minh City, when receiving the patient, the Emergency Department immediately activated a red alert, synchronously mobilized emergency teams, orthopedic injuries, anesthesia, resuscitation and vascular surgery to minimize the time to take the patient to the operating room.
In each rotation, the department always has a micro-surgist on duty 24/7, ready to handle cases of limb rupture or damage to the neural network that needs urgent connection, said Dr. Binh.
For example, last week, the department handled two serious cases: a 57-year-old male patient with a severed ankle and a 46-year-old male patient with a severed 1/3 of the lower leg caused by a grass cutter. Both underwent surgery to reorganize bones, connect blood vessels, tendons and nerves. Up to now, all expenses have been saved and are recovering well.
However, according to Dr. Binh, the cases of severed limbs encountered many difficulties. First is initial first aid at the scene and the time of transfer. Many patients in far away Xuyen Moc (formerly Ba Ria - Vung Tau), or Vinh Long province, took 46 hours from the time of the accident to Cho Ray Hospital. Meanwhile, the "golden time" for successfully connecting expenses is now only about 4 hours, provided that the broken expenses are properly preserved.
Second is the issue of preserving the disjointed expenditure. Doctor Binh emphasized: the limbs need to be wrapped in a clean cloth or cloth, put in a sealed plastic bag and then put in a ice bucket ( stone + water) to cool well; do not put the limbs directly in dry ice because it can easily cause cold burns, reducing the chance of success. Many cases come in a state of contamination (land, grass), or are only put in plastic bags without cooling them, causing great difficulty for surgeons when having to wash and clean before connecting.
Third is the motivation factor: if at the scene there is no good blood retention, the patient may be shocked due to severe blood loss, making the surgery more dangerous and prolonged. Finally, limb connection is a sophisticated cosmetic surgery, requiring a microscope, only a very small step to connect blood vessels, tendons, and nerves; the surgery can last 58 hours and needs to be closely monitored at least 72 hours after surgery.
Regarding the ability to recover, Dr. Binh said that for lower limbs (legs and feet), the recovery rate is relatively high if: bones are firmly fixed, blood vessels and software are non-infective, and the patient complies with rehabilitation function. Meanwhile, hand joints are more complicated because they require delicate movements and require long physical therapy time.
Doctor Binh recommends that workers strictly follow labor safety measures: wear protective shoes, use protective equipment on a grass cutter, limit removing safety covers. When an accident occurs, do not apply folk methods such as alcohol or cigarettes to wash wounds, but rather stop the bleeding, store the limbs properly and transfer them to the nearest medical facility as soon as possible.
C corrective first aid and quick transfer are a big decision to save the cost of life, Dr. Binh emphasized.
