Ingenious surgeons have helped save a Brazilian man’s hand from being amputated by putting it inside a 'pocket' in his belly.
Doctors decided to bury Carlos Mariotti’s left hand inside his abdomen and cover it with a flap of protective skin, after the machine production operator suffered a horrific work accident that ripped off all the skin on his hand.
The 42-year-old who lives in Orleans in the south of Brazil, must now keep his damaged hand inside the soft tissue pouch for six weeks.
Orthopaedic and traumatology doctor, Boris Brandao, who performed the rare operation, explained: “(Mr Marriott) suffered a de-gloving injury which left him with very little skin on the palm and back of his hand, exposing the bones and tendons inside.
“This was a very large and delicate injury and the only place we could fit the whole hand was in the abdomen. Without this procedure, there would be a high risk of infection and the tissue and tendons would rot away,” Dr Brandao said.
Mr Mariotti who remains hospitalised in the Santa Otília Hospital said he is a very lucky man: “I still get very emotional when I think about the accident. But it was only when doctors told me I could lose my hand that I realised the gravity of the situation.
“When I woke up from the operation I didn’t know whether it was still there. I couldn’t believe it when they said they had tucked my hand inside me.”
Heavy bandages around the man’s midriff keeps his arm firmly in place. But doctors have warned that he must move the hand “gently around to avoid [it] becoming stiff.”
“It’s a really weird feeling trying to wiggle my fingers inside my body and creepy seeing my tummy protrude slightly as I prod around,” Mr Mariotti said.
The right-handed factory worker lost two fingers - his index and middle fingers - in the accident but said: “I am just so grateful because at least I will still be able to hold a fork, grip a steering wheel and dress myself without any help.”
Mr Mariotti was operating a machine that manufactures coils at a plastic factory, close to where he lives, when his hand was dragged into the heavy duty equipment.
The experienced factory worker said: “It was like watching a movie play out in front of me. I saw the machine pulling my hand in and couldn’t do anything about it.”
When colleagues did not immediately respond to his screams, the desperate worker took drastic action, wrenching his hand out of the machine himself.
Workmates came running seconds later and tried to save the hand by wrapping it tightly in bandages.
Dr Brandao said medics decided to perform an immediate “salvaging” procedure because “if we can save a hand we always try to find a way to do so.”
He explained: “In order to keep the wounded hand alive, we opened the abdomen, took off the skin and put it inside the cavity to protect it. The patient’s hand must stay in the pocket for about 42 days to ensure it develops new tissue and tendon material which is capable of receiving a replanted skin graft.”
Weekly check-ups will monitor the progress of the treatment and whether the hand is on the mend.
However, the doctor warned: “Mr Mariotti will suffer impaired function as he will not get all the movement back in his hand.
“But he will have a working hand and will be able to do the pincer movement. At least this is a better quality of life compared to having an amputated hand,” he said.
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