Our Summary

This research paper talks about different ways to repair damage to the soft tissues of the hand, focusing on the fingers and thumb.

If the damage is small or moderate, they usually fix it using nearby skin (local flaps). But if the damage is quite big (around 3 cm or more), they use a piece of tissue with its own blood supply from another part of the body (vascularized free flap).

Fixing the thumb is very important, and if all fingers are lost, they need to reconstruct at least two. If only the end of a finger is missing or if only one finger is lost, they can rebuild it, but this is more for looks as it’s not necessary for function.

Feeling in the thumb or finger tip is very important, so they always check this (sensory evaluation) before deciding on the best surgery.

FAQs

  1. What methods are used to repair small to moderate damage to the soft tissues of the hand?
  2. How is severe damage to the hand, specifically around 3 cm or more, treated?
  3. What factors are taken into consideration before deciding on the best surgery for hand damage?

Doctor’s Tip

One helpful tip a doctor might tell a patient considering a hand transplant is to carefully weigh the risks and benefits of the procedure. Hand transplants are complex surgeries with potential complications, such as rejection of the donor hand or problems with nerve regeneration. It’s important for the patient to understand the potential outcomes and be prepared for a long rehabilitation process. Additionally, they may advise the patient to follow a strict medication regimen to prevent rejection and attend regular follow-up appointments to monitor progress.

Suitable For

Patients who are typically recommended for hand transplant surgery are those who have experienced severe trauma or injury resulting in the loss of one or both hands. This can include injuries such as amputation, severe burns, or crushing injuries that have significantly impacted the function and appearance of the hand.

Candidates for hand transplant surgery must also have a good overall health status and be able to comply with the rigorous post-operative care and rehabilitation that is required for a successful outcome. Additionally, patients must have realistic expectations about the potential risks and benefits of the surgery, as well as the long-term commitment required for ongoing care and monitoring of the transplanted hand.

Overall, hand transplant surgery is considered for patients who have exhausted all other treatment options and are seeking to restore function and improve quality of life following severe hand trauma or injury.

Timeline

Before hand transplant:

  1. Patient undergoes evaluation by a team of surgeons, psychologists, and other medical professionals to determine if they are a suitable candidate for a hand transplant.
  2. Patient undergoes extensive physical and psychological assessments to ensure they can handle the physical and emotional demands of the surgery and recovery process.
  3. Patient receives counseling and education about the risks and benefits of hand transplant surgery.
  4. Patient is placed on a waiting list for a suitable donor hand.
  5. Once a donor hand becomes available, patient undergoes the transplant surgery, which can take several hours to complete.

After hand transplant:

  1. Patient undergoes intensive physical therapy and rehabilitation to regain function and strength in the transplanted hand.
  2. Patient takes immunosuppressant medications to prevent rejection of the donor hand.
  3. Patient undergoes regular medical check-ups and monitoring to ensure the success of the transplant and detect any signs of rejection.
  4. Patient may experience psychological challenges and adjustment issues as they adapt to their new hand.
  5. Over time, patient gradually regains sensation and function in the transplanted hand, allowing them to perform daily tasks and activities.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a hand transplant surgery?
  2. How long is the recovery process and what can I expect in terms of rehabilitation and physical therapy?
  3. Will I need to take immunosuppressant medications after the transplant, and what are the potential side effects of these medications?
  4. What are the expected outcomes in terms of hand function, sensation, and appearance after the transplant?
  5. How many hand transplant surgeries have you performed, and what is your success rate?
  6. How long will the transplanted hand last, and will I need additional surgeries in the future?
  7. What is the process for finding a suitable donor for the hand transplant surgery?
  8. How will the transplant affect my daily activities and quality of life?
  9. Are there any alternative treatments or procedures that could be considered instead of a hand transplant?
  10. What kind of support and resources are available for patients undergoing a hand transplant surgery?

Reference

Authors: Adani R, Tang JB, Elliot D. Journal: J Hand Surg Eur Vol. 2022 Jan;47(1):89-97. doi: 10.1177/17531934211051303. Epub 2021 Oct 20. PMID: 34670437