Anyone know anything about amputations?

[Laura PourMeADrink]

Backstory: My son, Scotty, was over his girlfriend's parents house. He heard her dad scream HELP and he ran to the back deck. Bill had had an accident with the power saw. He cut his entire hand off. Scotty grabbed a climbing belt, tied a tourniquet, called 911, picked up Bill's hand and put it in an ice bag. The paramedics were there in 2 minutes flat.

Bill went into surgery to attach his hand (a 12-hr operation). After two hours, his heart almost stopped and they shot it with epi. They stopped and said there was too much risk. No more hand.

Their first idea was to attach the wrist to his hip for three weeks to get the blood flow and ready for skin graft. But, now, they are pushing to saw off his wrist to allow for enough skin to cover the end of his arm.

Does anyone know - should he push for the first option? If you have no hand, is a wrist important?

[Buddha_of_Wisdom]

1. He will probably have a prosthetic hand

but if the nerves on the end of the wrist can be saved, then another surgery could be arranged to make the hand mimic its original intention...

I am sorry about your son's girlfriend's dad, and hope he gets better and makes the right choices.

It is an life altering event for him.... make sure that he gets all the support he needs.

[Laura PourMeADrink]

9. thanks. I need to research it all. I don't really get how nerves are severed and remain "saved" n

[NYC_SKP]

2. Oh Jesus Lord!!!

Oh dear. OK, I have a little experience working with prosthetics and appliances, my grandfather lost his leg and my mom had polio in both legs and I've even been to trade shows on the subject.

From that point of view, that a working prosthetic hand may be fitted, I would advocate for KEEPING as much of the forearm as may be needed to make for the best potential working prosthetic hand.

Now this might mean leaving as much as possible and grafting skin from the thigh or buttocks,

Or it might be better to cut it back some distance from the injury.

I would look at it from the prosthetic point of view over any aesthetic goals.

Good lord.

Good luck, keep us informed.

[Laura PourMeADrink]

17. Thanks so much sweetie ! You are such a nice person! (bet you

hear that ALL the time).

Sounds like the key to to do whatever you need to do to save the most of one's body but only what is healthy.

[Recursion]

3. That's horrifying

I had two friends lose hands in Iraq; I can ask them if you want? (It's not really been something we talked about much...)

[Laura PourMeADrink]

10. no....wouldn't want to you to bring up what must have been a million times more

horrific than a home saw accident.

[Recursion]

11. They both do amputee/prosthesis advocacy now, which is why I thought of them

Last I heard they had started a non-profit that matches military surplus prostheses with poor people in the US and abroad (that was a few years ago though). it might be worth an email; I'll see if they're still doing that.

Also, mad props to your son for keeping his cool and applying correct first aid!!!

[Laura PourMeADrink]

19. You rock Recursion. thank you so much.

[pkdu]

4. I would imagine having a functioning wrist with a prosthetic hand would be way better than not

Having a wrist...question is, is it functioning?....if not, sounds like not much difference.

I'm not a surgeon , nor have I stayed at a Holiday Inn recently.

[Laura PourMeADrink]

18. How was the Holiday Inn? :>)

Yes, seems like common sense to me. I have been sitting here moving my wrist. It seems like I can control it with my arm muscles - but maybe you need both? hand and arm?

[arthritisR_US]

5. I'm very ignorant when it comes to these matters but my gawd your son was

impressive with his cool head and command of matters. Whatever happens he gave him his best chance, IMHO. What a kid!

[Laura PourMeADrink]

8. I was very impressed too. I vowed to never criticize him again for not having his phone

or taking too long to get something done. It's weird, this happened yesterday and he told me the event keeps going through his mind over and over again. I think he has some guilt about not actually being with him and preventing what happened. He had warned him many times about the safe use of the saw. Bill was using is while smoking a pipe (which scott found later sawed in half).

[arthritisR_US]

15. Those who do the most, are the ones burdened

with the guilt of not being able to prevent the inevitable and yet they are the ones the universe relies on to prevent any further carnage... His internal compass is well calibrated, he learned that somewhere

[Warpy]

6. The more they have to work with, the better a prosthetic hand will work

so he needs to push for them to save as much as they can. The con is being in an uncomfortable position for 2-3 weeks. Amputating back 4 inches or so to have enough skin and muscle to create an immediate flap will have him out of the hospital earlier and a prosthesis might be more comfortable with a good flap, but it will be less functional without a movable wrist.

So there are pros and cons to each. I'm assuming the docs have discussed this with him so he can make an informed decision.

[Laura PourMeADrink]

13. thanks Warpy. I am going to pass that on to my son. He is getting a strong feeling

that the doctors are pushing for the further amputation - to do just that - free up the bed. But glad to know there are potential advantages to that. Bill's wife is for that - just to "get him home."

I have kind of advised Scotty to state his opinion and bow out. It is really not his place - but the immediate family's

[LeftyMom]

7. They'll need a lot of that self-adhesive compression bandage for wound care.

A friend was buying that stuff at the pharmacy after her bf's amputation, and it cost a fortune. He needed it for a very long time and it wound up being a huge expense. In retrospect she'd have ordered a case from somewhere.

FWIW, the effort to leave too much damaged tissue on in the hope that he would be able to control a prosthesis ruined his life- he had a lot of pain, became addicted to painkillers, burnt all his bridges, it was the start of a real downward spiral. I guess that's one of those things one only knows in retrospect, but if there's a lot of nerve damage and pain is a real possibility that's something worth considering.

[Laura PourMeADrink]

14. thanks so much....so just so I understand "leave too much damaged tissue" You mean

the most important consideration is to focus on saving whatever tissue is undamaged and healthy and let the rest follow.

[LeftyMom]

22. I'm not a doctor, all I know is that in my friend's bf's case,

nerves that were known to be damaged (in his case near his elbow) were left in the hope that he'd be able to control a prosthesis. He never did (and eventually he went back under the knife to get a higher amputation,) but the pain was a real problem in his case because it led to a pain killer addiction that really destroyed his life.

I don't know if that's a common problem, but it was a really life-altering mistake in his care. :/

edit: Jostling him around was a real problem for a long time. If they can beg, borrow or steal a vehicle with a very smooth ride for use while he's healing they'll be glad of it.

[undeterred]

12. A man I worked with cut a finger off cleanly

when nobody else was at home. He put it on ice and drove himself to the hospital. Said he was so freaked out that it really didn't hurt that much. He got there in 20 minutes and they were able to reattach it.

Didn't work quite the same as before but it was still a finger and he was glad to have it.

Good thing it was not a stick shift vehicle.

Losing a whole limb - thats a lot more complicated.

[kestrel91316]

16. I've done a number of amputations, but NOT IN PEOPLE, lol. This one is way above my pay grade.

I would let the doctors use their best judgement on this one.

[panader0]

20. Kudos to your son Scotty for his cool head

in a horrific situation. I've been around some bad cuts but not like that. Wow.

[Vinnie From Indy]

21. WTF? What kind of power saw was this guy using?

A band saw could easily remove a hand in short order, but most saws, it would seem, would take a bit more effort to get clear through an entire wrist.

[Electric Monk]

23. Yeah, no shit. You'd think he'd stop cutting when it started bleeding and/or hurting.

/just sayin

[gopiscrap]

24. OMG you folks are in my prayers!