Previously, around 11 PM on October 16, patient P.T.C. (40 years old, residing in Đồng Tháp province) was transferred to Chợ Rẫy Hospital (HCMC) in a state of severe hemorrhagic shock and multiple injuries, including stab wounds to the chest, back, and both hands. One hand was completely severed, while the other remained attached by only a partial skin bridge and bone.
Upon reviewing the medical history, Mr. C. sustained severe injuries with both hands severed in an altercation with a neighbor.
Doctors at Chợ Rẫy Hospital examining the patient's severely injured hands after a brawl.Doctors at Chợ Rẫy Hospital examine the patient’s two hands (Photo: Hospital).
Immediately upon admission, Chợ Rẫy Hospital activated a red alert protocol, mobilizing staff from the Emergency Department, Orthopedic Trauma, and Anesthesia-Resuscitation for coordinated treatment. After blood transfusions and hemodynamic stabilization, the patient was quickly moved directly to the operating room.
Dr. Trần Phước Bình, an orthopedist (First Degree Specialist), stated that this was one of the most complex and stressful surgeries. The operation lasted for 12 hours with the participation and coordination of three surgical teams from the Orthopedic Trauma Department.
The first team performed initial treatment on both limbs, cleaning, bone fixation, and preparing for microsurgery. By early morning, the hand microsurgery team continued to reconnect blood vessels, nerves, and tendons for both hands. For the right hand, which was nearly severed, doctors performed bone fixation and reconnected blood vessels and nerves under a microscope.
The completely severed left hand presented more challenges for the doctors due to complex injuries and unstable hemodynamic status; at one point, the team had to reopen the wound to re-anastomose the blood vessels.
By 1 PM the next day, the surgery concluded successfully, with both hands appearing pink, warm, and showing good signs of viability. Ten days after the limb replantation microsurgery, the patient underwent additional skin grafting.
Currently, after a period of physical therapy for rehabilitation and monitoring of vital signs, the patient’s condition is stable, both hands are viable, and he has been discharged from the hospital.
Dr. Trần Phước Bình shared that limb replantation using microsurgery is a form of “supersurgery,” requiring high skill and modern equipment. At the Orthopedic Trauma Department of Chợ Rẫy Hospital, each on-call shift includes a limb microsurgeon to promptly handle complex severed limb cases upon admission.
Just one week after the above case, the hospital received several cases of severed fingers, hands, and feet, all of which underwent successful limb replantation surgery.
Dr. Bình advised that in recent times, the number of trauma cases due to altercations admitted to the department has tended to increase, mostly related to conflicts after alcohol consumption.
However, not all cases can be successfully treated if incorrect initial handling methods were used. The orthopedic trauma specialist emphasized that in the unfortunate event of an accident, correct initial first aid is crucial.
Accordingly, the patient’s wounds need to be stopped from bleeding, and the severed limb portion should be quickly preserved by wrapping it in a clean bandage, placing it in a sealed nylon bag, and then putting the bag into an ice container (do not immerse directly). Afterward, the victim should be swiftly transported to a medical facility capable of performing microsurgery for timely management and treatment.
