April 19, 2017

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Nay Pyi Taw doctors reattach hand severed at the wrist

The medical team at Nay Pyi Taw 1,000-bed Hospital that performed the reattachment surgery on 3 March.
Dr.Thida Hla, Medical Superintendent. Photo: Kyaw Ye Swe

A man’s hand that had been cut off at the wrist after a sword attack was successfully reattached by a medical team at Nay Pyi Taw 1,000-bed Hospital, only the fourth successful instance of limb reattachment in Myanmar history.
Professor Dr. Zaw Wei Soe of University of Medicine 1, numerous surgeons, and an anaesthetia team led by Professor Dr. Kyaw Aung Htun performed the multi-stage operation.
Ko Aye Htun, a farm worker from Thagaya, Yedashe Township, Bago Region, had his right wrist severed and his head injured on the morning of 3 March when he was attacked by a fellow farm worker armed with a sword.
“I put up my hand to protect myself and didn’t even realise my hand was cut off at the wrist”, Ko Aye Htun said.
“I wrapped my wrist stump in a cloth and went to Swa hospital. Swa hospital was not capable of providing proper treatment and I was sent to Nay Pyi Taw 1,000-bed hospital around 11am.

The right hand of Ko Aye Htun after reattachment surgery.

When the hospital discovered that Ko Aye Htun did not bring his severed hand, hospital officials had to send someone back to Yedashe Township to retrieve the hand, he said. By the time the limb was recovered and brought to the hospital in Nay Pyi Taw, it would be late in the evening when the reattachment surgery could begin. Ideally a severed limb must be reattached within six hours. It had already been over 10 hours by the time the operation began.
“It was already 4pm when I reached the hospital, and I was operated on at 11pm”, Ko Aye Htun said. “I don’t remember anything after that”.
What occurred after that was a deliberate, focused effort by dozens of doctors and nurses who worked as a team for several hours.
“First, the cut-off hand was cleaned and cooled with ice while the patient’s wrist, above the cut, was cleaned”, said Dr. Kyaw Aung Htun, a surgeon at Nay Pyi Taw 1,000-bed hospital. “First the bone was reattached with a steel rod and then the arteries were reattached. The cut on the patient’s head was also treated.”
After the initial operation, the patient’s wounds were treated with medicine every other day, Dr Kyaw Aung Htun said. Once the condition of Ko Aye Htun stabilised, reattaching of the nerves was made on 4 April.
“There were three stages in this treatment. First, we ensured that blood flowed through the arteries. Second, we attached the nerves. Third, and finally, we covered the affected area with skin from the thigh”, Dr. Kyaw Aung Htun said.
The successful reattachment of a limb was only the fourth in Myanmar history, and a first for Nay Pyi Taw 1,000-bed Hospital.
“Around 1980-90, Professor U Myo Myint of University of Medicine 1 conducted the first successful hand reattaching operation in Southeast Asia. Afterward, Professor U Khin Maung and team conducted many successful hand reattaching operations. It is the first successful operation in Nay Pyi Taw 1,000 bed hospital, and Ministry of Health and Sports is very happy and proud to announce this at the time of our New Year”, said Dr. Zaw Wei Soe, Professor of Medicine at  University of Medicine 1.
“Success in this operation is achieved through teamwork. Teamwork that involves the ambulance that took the cut-off hand, treatment provided at the emergency ward and operation to reattach the hand. It is important for us all to do it together”, Dr Zaw Wei Soe said.
“It is a very proud time for the hospital”, said Dr. Thida Hla, the Chief Medical Officer for Nay Pyi Taw 1,000-bed Hospital. “Nay Pyi Taw 1,000-bed Hospital provides treatment free of charge, and this patient was similarly provided.”
Over a month later, Ko Aye Htun is recovering and is thankful to the talented medical professionals who were able to save his hand.
“Now I can move a little even though it still hurts a bit. I’m told it will be completely healed in about six months. I thank everyone. Except for my food, everything is provided free in this hospital”, Ko Aye Htun said.

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