Man successfully reattaches amputated thumb at home to avoid going to hospital
The 25-year-old surgical intern cut part of his left thumb off while using a kitchen knife but managed to graft it back onto the "stump" without attending the emergency department
A surgical intern who accidentally amputated part of his own thumb with a kitchen knife successfully reattached the missing piece at home because he didn’t want to go to the emergency department.
The 25-year-old man sliced off a portion of the “finger pulp” and nail bed from his left thumb while cooking, and managed to control blood loss by applying pressure to the site of the wound.
He decided not to attend the emergency department because the incident occurred during the Covid-19 pandemic, according to a case report published in the latest issue of the Irish Medical Journal. Instead, he replaced the amputated portion of his thumb onto the “stump” and affixed it using a simple compressive dressing.
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Two days later, the surgical intern inspected the wound to decide whether or not the piece that had been cut off his thumb should be discarded. However, he noticed that it contained a layer of skin that appeared viable, and granulation tissue was forming, suggesting that it was healing.
Following some informal consultation with an experienced hand surgeon, he therefore decided to trim the skin around the amputated portion of his thumb and try to graft it back on. After cleaning it with alcohol wipes, the tip was carefully placed back on the wound. No stitches were used and it was affixed using antiseptic dressing, with “reasonable” pressure applied to maximise contact with the injury.
After two weeks, the reattached thumb tip was “soundly healed”, and the residual pain tapered over the course of approximately three months. Sensation returned to normal in the thumb after five months. Eleven months after the incident, the finger contour and tissue bulk were reported to be normal. No complications occurred, and the patient had been able to work as normal during the recovery period.
The case report was co-authored by the patient himself, and it noted that there were no previous reports of simple trimming of dead skin from the edges of amputated flesh to enhance graft take.
“This novel, low-tech approach can be performed in the emergency department without specialised equipment, and represents a valuable tool for the outpatient management of minor fingertip injuries,” they wrote. “There are no previous reports of this technique being applied to fingertip injuries, where it is uniquely advantageous as there is no need for a donor site.”
The authors said the three-day delay between the injury occurring and the grafting taking place had allowed time for granulation tissue to develop “both on the stump and the amputate”, and this had increased the chances of the procedure working.
“There is understandable belief that skin grafting is a specialised technique that is reserved for severe injuries. Here, it is demonstrated that a traumatically amputated piece of skin can be relatively easily prepared and applied to assist wound healing, without any specialist training, outside of the hospital setting, with good short and long-term results,” they concluded.
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