NEW DELHI: A Haryana farmer’s quick thinking helped save the life and limb of his three-year-old boy, whose arm was severed from the chest wall while playing in the farm land. In an intricate, 10-hour surgery, which doctors said hasn’t been earlier reported in medical literature, the limb was replanted at Medanta Medicity , Gurgaon.

The right arms of the victim, Divyansh, got torn off after getting caught in a tresher at Gudana village near Bhiwani, Haryana. His father, Arvind Sangwan, wasted little time in carrying the boy and the limb on a motorcycle to the nearest hospital, where the severed part was put in an ice-bag and the case referred to Medicity.

The surgery began within two hours of the accident and continued overnight. Doctors said Divyansh will get back sensation and movement in the arm in about six months.

The father of a three-year-old boy, whose right arm was cut off from the chest wall in a thresher accident, said he never thought the severed hand could be rejoined.

“I took the child him to a nearby dispensary on a motorcycle because there was no ambulance. When we reached the local dispensary, they immediately referred us to another hospital where the first aid was done and the doctors preserved the severed arm in an ice-bag before sending us to Medanta Medicity for surgery,” said the father, Arvind Sangwan.

He said the accident happened in a flash and no one had clue till three-year-old Divyansh’s arm was completely torn off.

“Divyansh was playing below the trolley in which grains are collected. We did not notice when he reached the thresher machine and his hand got caught in the machine’s belt. His cries could not be heard due to the noise of the machine. When I saw him, he was lying in a pool of blood, his arm completely severed,” he said.

Dr Sanjay Mahendru, senior consultant, plastic, aesthetic and reconstructive surgery at Medanta Medicity, said he had not come across any report of re-plantation of an upper limb at this level (chest wall) in medical literature.

“The operation was started within two hours of receiving the child as any delay could have been detrimental to success. The surgery continued overnight and took nearly 10 hours,” he added.

He said two teams of doctors were constituted as soon as the patient arrived. While one was preparing the child for operation the other team prepared the hand for re-plantation by cleaning the debris, dissecting and tagging the blood vessels, nerves and muscles.

“Unlike a severed finger or part of the arm, here the whole arm had severed along with the shoulder blade from the chest wall. A vein had to be grafted from the child’s leg to connect the vessels in the arm to the shoulder,” said Dr Rakesh K Khazanchi , director, plastic aesthetic and reconstructive surgery at the hospital.

He said the patient was kept in pediatric ICU for three weeks after the operation to minimize the risk of infection.

The doctor added that neural recovery, related to sensation and movement of the arm, will take another six months to a year. “Diyansh does not remember how his arm got stuck in the thresher. He is just curious about the scar on his upper limb. We hope that his hand movement will be fully restored,” said Divyansh’s father.

Hospital chairman and MD, Dr Naresh Trehan , said parents need to be careful with active children. “We get a lot of cases of children who get their hand severed in heavy machinery, especially from the rural areas. This suggests that parents are not being careful enough,” he said.

Dr Khazanchi said just as agricultural equipment like threshers are deadly in rural areas; doors are the most hazardous spots for children in urban set-ups. “The largest number of urban cases we receive are door crush injuries of children, followed by those due to treadmills and washing machines,” said Dr Khazanchi.

He said that such patients should be taken to the nearest centre that conducts re-plantation surgeries as soon as possible. Also the severed body part should be cleaned properly by the local doctor, wrapped in a plastic bag and put in ice. It is essential to make sure that the body part is not in direct contact with the ice, say experts.