Doctors at Bai Jerbai Wadia Hospital for Children (BJWHC) in Parel have managed to repair and restore the hand function of an 8-year-old boy, which was severely deformed and scarred from an infection caused by a snake bite.
Talha Umar Shaikh from Nanded was playing with his toys, kept behind a cupboard, when a cobra hiding behind the cupboard bit him. Talha was immediately taken to a local doctor, who treated him with an anti-snake venom injection.
A few days later, it was noticed that Talha’s left hand had swollen up due to cellulitis and he had developed an infection. The local doctors suggested that amputation was the only option, but his parents took him to a a government hospital in Mumbai.
The hand was saved, but the healing was slow. With no primary wound cover provided, Talha developed a severe contracture and deformity of the left wrist and hand. His parents then brought him to BJWHC Parel, to see if his hand could be made functional.
Dr. Nilesh Satbhai, plastic, hand and reconstructive microsurgeon at BJWHC said, “When the patient came to me, he was unable to perform any useful activities with his deformed left hand. The severe skin and muscle necrosis on his hand and forearm had resulted in gross functional and cosmetic deformity. We planned a surgery to correct it. Microvascular surgery in children is complex and relatively uncommon. Hence it is only performed at well-equipped tertiary care centres.”
Dr. Satbhai said that the scarring was severe and extensive, which made surgery complicated. He said, “Our objective was to achieve full range of movement of the wrist and hand. The thickened scar over the left forearm and hand were excised. The stiffness and contracture of the left wrist and hand were released and complete range of movement achieved.”
Doctors at BJWHC created a flap consisting of skin and soft tissue from the left thigh. The blood vessels of the flap were connected to those in the forearm by microvascular technique using a microscope. “The musculotoxic venom of the snake had also caused some scarring of the tissues and blood vessels. Hence the technical challenge and risk involved in this case was higher than usual,” Dr. Satbhai added.
Mahetab Shaikh, the boy’s father, said, “We were worried that Talha could not hold any object or make a fist. But now the wounds have healed and hand movements have started after physiotherapy.”
