Helios Hildesheim: Saved from amputation after contusion
When Friedhelm Bühmann felt physically unwell at the beginning of the year, he went to see his GP. He diagnosed him with a flu-like infection and put him on sick leave for a week. At the end of the week, Bühmann suddenly passes out and falls. Within three days, his right hand becomes very swollen and painful. On a Saturday in early March, he visits the emergency room at Helios Hospital Hildesheim. Here it is discovered that although nothing is broken, immediate action is required. The man from Salzgitter had a progressive soft tissue skin infection that needed to be treated immediately. Bühmann was operated on the same day. And again the next day. At the same time, he was given antibiotics to stop the infection. The doctors knew that if the infection continued to progress so quickly, his hand would have to be amputated. The rescue was also successful thanks to a special measure. The dead skin had to be replaced with new skin. To do this, the hand was sewn to the patient's groin for three weeks. With success.
"I didn't realize how serious the situation was,"
says Friedhelm Bühmann today.
The 53-year-old is an open and communicative person who radiates a lot of joie de vivre. As a warehouse worker, he needs his hands for work every day. Like most people, he could never have imagined that he could lose them just because of a fall. However, the plastic surgeons at Helios Hospital Hildesheim recognized the seriousness of the situation immediately.
"Mr. Bühmann had developed a severe infection with a streptococcus variant that produces certain toxins and thus kills tissue. This was triggered by microtraumas in his hand, which he sustained in the fall,"
explains Nikolaus Unbehaun, Head Physician at the Clinic for Plastic, Aesthetic and Hand Surgery. The patient developed a so-called necrotizing fasciitis. In this bacterial soft tissue infection, which is as rare as it is dangerous, the infected tissue dies suddenly and very quickly along the affected fascia. Bühmann's hand was therefore operated on twice within 48 hours to remove the dead tissue. "Otherwise more and more tissue would have been killed off and we would have lost the hand," explains Unbehaun. After three weeks, the doctors had the infection under control with the help of additional medication.
Three weeks of flap training on the groin
The dead tissue on the hand was to be replaced by a skin graft from the patient's groin. To ensure blood flow to the skin flap, the surgeons surgically connected the hand to the groin for three weeks. During this time, so-called "flap training" was carried out. This involves deliberately interrupting the blood flow between the hand and groin time and again. Initially for just five minutes, then for up to two hours. "This creates new vessels in the skin flap and it learns to take care of itself," explains Dr. Rameez Razzaq, Senior Consultant in Plastic Surgery. He operated on and looked after Friedhelm Bühmann together with Head Physician Unbehaun. This procedure requires good cooperation and a lot of self-discipline from the patient. "For three weeks, I was almost only allowed to lie down and not leave the room because of the risk of infection," recalls Bühmann. But the effort was worth it. Thanks to disciplined follow-up treatment with the physiotherapists and occupational therapists at the Therapy Campus in the hospital, he can already use most of his hand again. His thumb is already fully functional. "This is not a matter of course and could only have gone so well because Mr. Bühmann cooperated so well," says Razzaq. He has just been to the clinic for the first flap thinning. This involved removing excess skin from the transplant to create a more visually appealing hand. "I also cycle a lot. That softens the hand," says Friedhelm Bühmann and signs a form with it.
Read more:
Do you need more information about Helios Hospitals or want to schedule your treatment?