When a Brazilian man severely damaged his hand in a work accident, doctors took a unique approach and sewed his hand into his abdomen.
Former machine operator Carlos Mariotti, 43, lost all the skin from his hand and fingers in the horrific, March 2016 accident when his hand became trapped between two coil rollers in an industrial machine used to make plastic tableware.
It destroyed his tissue, severed blood supply and left the bones and tendons on his hand exposed.
In an effort to avoid amputation, doctors decided to try to salvage Mariotti’s hand by surgically placing it in the soft tissue of his stomach.
The placement helped prevent infection and necrosis from setting in, while allowing the limb to reconnect its blood supply and restore muscle and tissue.
“I had never done this procedure before but I knew what was possible. We separated the skin from the abdominal muscles and created a bag inside and put the patient’s hand inside,” said Dr. Boris Brandao of Santa Otilia Foundation Hospital.
Mariotti’s hand remained inside his abdomen for 42 days.
“It was a really weird sensation because I could feel my fingers wiggling inside my body,” Mariotti said. “When I moved them around, my tummy protruded.”
Doctors told Mariotti to keep his hand pushed inwards and fingers moving so they didn’t freeze up.
"Every day, I reminded myself that I couldn’t take my hand out because it was in a pocket. I was terrified I’d break the stitches and damage my chances of recovery,” Mariotti said. “The pain was unforgettable and unbearable. I struggled to sleep because I couldn’t turn on my side or lie on my front.”
Carlos underwent two further operations in May 2016, the first to remove his hand from his abdomen, with the skin of his abdomen covering the back of the hand.
The third procedure, seven days later, involved splicing skin from Carlos’s left thigh and grafting it onto his palm. Unfortunately, areas of the transplant died within a few days and sections of the damaged skin had to be cut from the palm.
Doctors shaped it like a boxing glove with a small thumb and puffy flesh where his fingers used to be. They also used skin from his thigh for the procedure.
They hope to pioneer a surgery in the future that will restore full use of Mariotti’s fingers.
Mariotti’s family has started a campaign to help pay for the surgery as the previous surgeries were performed out of the kindness of Dr. Brandao’s heart.
"I never imagined in my wildest dreams that doctors would take this incredible step to save my hand. Now I want to complete the journey, rebuild my life and return to work to support my family,” Mariotti said.