• Surgery to cost not more than Sh400,000. Cost to be fully paid by the National Hospital Insurance Fund.
• Dr Wabwire said a severed limb should be stored in a plastic bag or any plastic container immediately after the accident to avoid contamination.
Doctors at Kenyatta National Hospital have achieved yet another milestone after reattaching the severed hand of a seven-year-old boy.
Doctors at Kenyatta National Hospital have achieved yet another milestone after reattaching the severed hand of a seven-year-old boy.
The successful operation on Benevolence Iticha is the fifth to have been conducted by KNH doctors since 2018.
On the morning of October 4 Benevolence joined his father Antony Kigotho cut grass for their animals before going to church.
He was cheerful, oblivious of the danger that awaited.
As he excitedly wheeled the chaff cutter, his right hand was trapped by the blades and was completely severed just below the wrist. The palm fell to the grass. All his father heard was a loud scream.
Benevolence rushed to his mother Lydia Wanjiru, wailing.
"I saw the blunt hand bleeding, and wailed and called a neighbour," Wanjiru said.
It's the neighbour who picked the palm from the cut grass and brought it to Lydia.
“I thank God that I had the courage to pick the hand. I picked a shopping bag that was on the verandah, put the hand in it and set out straight for the hospital,” the mother said.
They arrived at the Nazareth Hospital in Kiambu from where they were referred to the Kenyatta National Hospital.
The hand was stored in a cool box per the requirement.
They arrived at KNH at about 9.30am and were received by the doctor on call, who alerted other surgeons.
Benevolence had already stopped crying, and appeared calm, his mother said.
He was wheeled to the operating room at 3pm and underwent a 10-hour surgery involving a team of anaesthetists, nurses, plastic surgeons and orthopaedic surgeons.
The palm was successfully rejoined.
On Wednesday, Benevolence appeared in public for the first time since the accident. He said he wants to become president in the future.
He had undergone another small surgery to correct the wound to allow for the hand to heal and is expected to be discharged soon once that area heals completely.
“October 4, 2020 would have gone down as one of those days that we would never forget in life but thanks to God. This is another success and it is an indication that we really have qualified doctors in this country. It is something to be proud of,” his father Kigotho said.
Benevolence is a Grade 2 pupil at Njenga Primary School in Githiga village in Githunguri, Kiambu county.
Image: MERCY MUMO
KNH head of plastic and reconstructive surgery Dr Benjamin Wabwire said Benevolence has still not regained full sensation on the palm.
“He is undergoing occupational therapy and physiotherapy because at the moment he may not have sensational feeling in the fingers as the nerves grow back which take time so someone needs to work on him,” Wabwire said.
“With Benevolence being a young child, we are optimistic that he will be able to return to full function and his brain will adapt accordingly as he recovers.”
Dr Wabwire said a severed limb should be stored in a plastic bag or any plastic container immediately after the accident to avoid contamination.
The medic advises that handlers should ensure that the amputated limb is maintained at high levels of hygiene to increase surgery success rate.
The recommended temperature is zero to eight degrees to help slow down the dying of cells.
They said the time one takes to get to the hospital is key in ensuring the success of the re-attachment surgery. It should not take more than 12 hours.
"Our greatest challenge has been that the person must arrive as soon as possible so that we are able to re-establish the blood connection in the amputated part," Wabwire said.
“We receive cases from as far as Kisii and Meru that get here past 10 hours. By then, most of the structures in the hand, the cells have already died.”
He said there were plans to ensure the availability of ambulances to airlift such patients within the shortest time possible.
Similarly, there are plans to ensure that the University of Nairobi trains enough medics who can attend to such cases in Coast and the Western regions.
This is the fifth successful surgery the hospital is conducting since 2018. The first case was that of 17-year-old Joseph Theuri, whose right palm was severed by a chaff cutter in Kihara, Kiambu county in January 2018.
Dr Wabwire said assembling the surgeons was not hard.
“The team knows that even if you are planning to go somewhere you have to postpone because it is a time issue. If you don’t do it within the specified timeframe the chances of success keep decreasing," he said.
The main challenge when dealing with children is that their blood vessels are still small compared to an adult, but Wabwire noted the advantage with children is that the chance of the surgery being successful if the structures are joined well is higher.
"So actually a child has a higher chance of success than an adult. The only challenge is that it requires a little bit of technical skill for you to do it because the structures are smaller.”
KNH said they are still working out costs of the operation and hospital care but said it will not cost more than Sh400,000.
The cost will be fully cleared by the National Hospital Insurance Fund.
Edited by P.O