Today's Edition
A. SREENIVASA REDDY (ABU DHABI)
The severed forearm of an industrial worker was successfully reattached in a challenging 10-hour operation at an Abu Dhabi hospital recently, following a workplace accident involving heavy machinery.
The incident occurred on September 29, when a routine workday turned into a medical emergency for 50-year-old Tanveerullah Arif, a resident of Al Dhannah City. While operating a lathe machine — work he had been doing for two decades — his left hand was caught in the machine, resulting in a complete amputation at the forearm level.
He was rushed to a nearby hospital for initial stabilisation before being transferred to Burjeel Medical City in Abu Dhabi for advanced care. A multidisciplinary team of specialists there undertook a complex emergency replantation procedure that lasted 10 hours, managing what doctors described as a rare and highly challenging combination of crush, avulsion and amputation injury.
The accident occurred around 4:30 pm, and the surgical team in Abu Dhabi was alerted an hour later. The patient arrived at the facility at about 8:15 pm, conscious but having suffered significant blood loss. He was immediately taken to the operating theatre, where anaesthetists stabilised him and prepared him for surgery.
“This is a successful replantation of a completely amputated mid-forearm complicated by a severe crush-avulsion injury,” said Dr Praveen Kumar Arumugam, Specialist in Plastic and Reconstructive Surgery. “Such cases are extremely complex and require rapid coordination and meticulous execution.”
During the operation, surgeons carefully examined both the severed limb and the injured forearm to identify muscles, tendons, nerves, arteries, veins and bones.
Damaged and contaminated tissue was removed before the two forearm bones were fixed using plates and screws. Surgeons then restored blood circulation by repairing two arteries and four veins, followed by reconstruction of muscles, tendons and nerves.
“In his case, restoring blood flow was the most critical step,” Dr Arumugam explained. “Without adequate circulation, the limb cannot survive. Our goal is to eventually give him a functional hand capable of grasping.”
The patient received six units of blood during surgery, while anaesthesia specialists closely monitored him to prevent reperfusion injury — a potentially fatal complication that can affect the heart or kidneys. Three days later, a second procedure was carried out to apply a skin graft to areas where skin had been lost.
The plastic surgery team worked alongside orthopaedic surgeons and anaesthetists in what doctors described as a carefully sequenced and coordinated effort.
According to specialists, the patient’s relatively good health and absence of underlying medical conditions played a positive role in the outcome.
Doctors noted that the so-called “golden window” for limb reattachment is typically about six hours. In this case, the severed arm was preserved correctly during transport, allowing surgeons to attempt replantation within that critical timeframe.
“It was not a clean cut like a knife injury,” said Dr Arivind Bhamidi, Specialist in Plastic Surgery. “This was an avulsion injury, where the limb is torn off, which makes reconstruction far more difficult.”
The patient, who is now undergoing recovery and physiotherapy, said he remembers how quickly the accident unfolded. “Everything happened so fast. I just touched the machine and it happened. I was conscious when they took me to the hospital,” he said, adding that he has already begun to regain some movement in his hand.
Doctors said the recovery phase will include ongoing physiotherapy and further assessments to determine whether additional procedures are required to improve function.
Though there is some basic movement, there remains a risk of permanent impairment in hand function due to the severity of the injury and loss of multiple muscle groups, Dr Arumugam told Aletihad.
The case also highlights the importance of correct first response in severe industrial accidents. In incidents involving crush injuries or amputations, emergency services should be contacted immediately, bleeding controlled with firm pressure, and the injured person kept calm and still. The severed part should be gently rinsed, wrapped in a clean cloth, sealed in a plastic bag and placed in another container with ice — without direct contact with ice or water — before rapid transfer to a hospital equipped for microsurgery.
Medical facilities at industrial sites should be equipped to control bleeding and provide first aid and wound dressing, Dr Arumugam said. “The medical staff on site should be aware of the correct way to preserve amputated parts,” he added.
