An East Timorese woman who lost her thumb in a workplace accident has regained hope after undergoing the Sunshine Coast region’s first toe-to-thumb transfer.
According to a report by ABC News, Francisca Amaral, 40, lost her left thumb in a conveyor belt accident at a produce factory in January. She had moved to the Sunshine Coast more than a decade ago for work and supports her partner, two teenage sons, mother and siblings, who remain in East Timor.
Amaral described the accident as “very scary”, saying she was “all alone” without her family.
According to ABC News, plastic surgeon Chandan Jadhav initially used skin from her forearm to cover the injury. Eight months later, on July 16, he performed the complex reconstruction at Sunshine Coast University Private Hospital.
Jadhav said patients needed time to “mentally prepare” for such a life-changing procedure.
“It's devastating, it's life-changing,” he said, as quoted by ABC News.
“There's so much loss, and there's so much psychological trauma.”
The 12-hour operation involved transferring Amaral’s entire second toe to her hand to create a functional thumb. Surgeons transferred the toe’s bone, tendons, arteries, veins and nerves before reconnecting them to the structures in her forearm.
“We took the flexor and extensor tendons, arteries, veins, nerves, along with the bone,” Dr Jadhav said.
“We stabilised it with plates and screws on her forearm, and then we connected the tendons of the foot to the tendons of the forearm,” ABC News has quoted.
The team then restored blood circulation by connecting the arteries and veins using microsurgical techniques.
Jadhav said the second toe was selected because of its similarity to a thumb and because most patients could continue walking normally without it, as reported by ABC News.
However, the procedure carried significant risks and required surgeons to work under a microscope at 12.5-times magnification.
“It's a very fine art of reconstruction by using microsurgical techniques to attach these blood vessels so that the blood flow is restored,” he said.
“If it doesn't work, then you're losing the person's toe as well,” he said.
“There's a lot at stake and you've got to get things right,” ABC News has quoted.
Jadhav said the procedure had an emotional impact on both the medical team and Amaral.
“It's very gratifying to see the tears of joy in the patient when she woke up,” he said.
“The very next day, she was able to wiggle that toe, which is now functioning like a thumb, and that gives you an immense sense of joy and satisfaction and gratifies us and defines what plastic surgeons can do and create,” as quoted by ABC News.
Amaral said she experienced significant pain after waking from surgery but was “very happy” with the outcome.
“My doctor is very good … they said everything will be OK,” she said, ABC News has quoted.
“They give a lot of hope and support,” ABC News has quoted.
She will undergo weekly hand therapy for the next six to 12 months, with doctors expecting her to regain at least 80 per cent of normal thumb function.
“I feel happy because I can use my thumb,” Ms Amaral said, as quoted by ABC News.
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