Twenty-three year old Lawrence (Lorry) Cooper has had his hand successfully reattached by Mater Plastics and Reconstructive surgeons in a rare marathon seven hour surgery with extraordinary outcomes.
After suffering a workplace accident which completely severed his hand below the wrist, Lorry had surgery within hours and was miraculously moving his fingers the very next day.
Thanks to Lorry’s quick thinking colleague, Lorry’s severed hand was preserved in ice, a tourniquet was applied to his arm to prevent blood loss and he was transported to Mater Private Hospital Brisbane.
Plastics and Reconstructive surgeons Dr Theo Birch and Dr Andrew Hadj established two teams in theatre in an attempt to reattach the hand to his arm. Each team cleaned and prepared the wound sites in preparation for reattachment.
Mater Plastics and Reconstructive surgeon Dr Theo Birch explains the complexity of reattachment.
“Before we could even consider reattachment we had to establish if we could reconnect the blood supply to the severed hand within a viable time frame,” Dr Birch said.
“Dr Hadj and I worked at each severed location, cleaning and preparing the site, identifying which blood vessels were ok,” he said.
If there is an upside to all of this, it was that Lorry’s wound was clean and sharp.
“There were no jagged parts to the bone, due to the clean cut making reattachment that bit easier,” Dr Birch said.
Easy probably isn’t the right word to describe what came next. Especially with such a tight timeframe for success.
For close to seven hours, Dr Birch and Dr Hadj performed meticulous micro surgery on Lorry’s hand. Starting from the inside out.
Mater Plastics and Reconstructive surgeon Dr Andrew Hadj explained the process for reattachment.
“We set ourselves a 4 pm deadline to get delivery of blood supplied to his hand or run the risk of cells and muscles dying,” Dr Hadj said.
“We generally worked in order of bone, tendons and muscles then vessels and arteries.
“Stabilising the bone is the first part of the puzzle and then treat the under and upper surface of the hand separately to repair tendons on both sides. At that point we repair arterial inflow and venous outflow to re-introduce blood to the hand,” he said.
Dr Birch said he and Dr Hadj were constantly talking to each other about which blood vessels were viable and locating an artery to support at the same spot in the hand so you can directly connect it.
“Unfortunately you can’t just connect an artery together straight away to restore blood flow as the construct is too flimsy,” Dr Birch said.
“You need to plate and screw the bones together, repair the deeper tendons–only then is it safe to focus on the fine micro vascular surgery,” he said.
Dr Hadj said it was rare to reattach a full hand.
“We usually reattach the odd finger or two but rarely the whole hand and this cut was in an unusual location,” Dr Hadj said.
Dr Birch said Lorry’s prognosis is positive considering the nature of his injury.
“His movement the very next day was promising,” Dr Birch said.
“We gave him a day’s rest, put it into a splint and got things moving to improve the chances of success.
“Cut nerves are the most unpredictable part of the process, because for a successful recovery they need to grow–which is a very slow process.
“Lorry is a young guy and we want to get him back to work and to participate in life in the way he needs to,” he said.
For Lorry, he’s under no illusions to the uphill battle that’s ahead of him.
“My rehabilitation is a daily thing and I’m pretty motivated to do it and also know not to overdo it which is a possibility,” Lorry said.
“It’s a long road to my recovery and we don’t really know exactly what that looks like but I hope I’ll be able to use my hand a bit more,” he said.