Reattaching an amputated limb is a race against time

Treating a simple fracture is different from reattaching a limb because in the latter case, bones, muscles, tendons and ligaments are exposed.

“The minute nerves of the area get damaged and the entire area is avulsed [forcibly detached from its normal position]. We have to not only clean the limb to be attached, but prepare the patient and conduct very minute repairing under the microscope, very often with a suture that is 0.5 millimetres thinner than human hair.

Sensation is everything. Even if we restore blood circulation, a limb is of no use unless it has full sensation and the damaged nerves are healed.”

Explaining the process, he said: “Time is of essence as the soft muscle tissue starts necrotising [rotting] within three to four hours. The outer limit is six hours after which it becomes irretrievable. So it is important to get the severed limb as soon as possible — within an hour — to the hospital.”

To save a severed limb, it is important to immediately wash it, clean the tissue, wrap it in a sterile piece of gauze, place it in a sterile bag, seal it and then place this bag in second bag containing chilled water not lower than eight degrees Celsius.

“The fluids within the limb crystallise in very cold conditions and it makes the limb irretrievable,” Dr Al Awadi clarified.

Once the limb arrives, Dr Al Awadi said: “One surgeon gets to work with the amputated limb while another works to prepare the patient. It usually takes between 4-6 hours of microscopic repair and suturing the restore the limb.”

The patient is then required to undergo intensive physiotherapy. It takes six to 12 months of intensive rehabilitation and physiotherapy to restore the limb to optimum capacity.