A MAN whose hand was saved after it was sewn inside his abdomen is set to have pioneering surgery – the first of its kind in the world – to restore full use to his fingers.
Former machine operator Carlos Mariotti, 43, from São Ludgero in southern Brazil, lost all the skin from his hand and fingers in a horrific workplace accident in March 2016.
His hand had been pulled into and trapped between two coil rollers in an industrial machine used to make plastic tableware.
The skin was torn off, destroying tissue, severing blood supply and leaving bones and tendons exposed.
However, quick-thinking surgeons decided that rather than amputate, they would salvage the hand by surgically tucking it into a soft-tissue pouch in his belly – where it stayed for 42 days.
“It was a really weird sensation because I could feel my fingers wiggling inside my body,” the married father-of-one said.
“When I moved them around, my tummy protruded as I prodded about.
"I was told by doctors to make sure I kept my hand pushed inwards and to keep my fingers moving so they didn’t seize 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.”
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Carlos currently has a left hand shaped like a boxing glove with a small thumb and a ball of puffy flesh where his four fingers should be.
He is already able to do basic tasks like hold his toothbrush as he puts toothpaste on, but Carlos is now due to undergo two new trailblazing procedures to radically improve the range of movement in his hand.
The first operation will divide Carlos’s hand into two sections, with two fingers each encased in the separated sections, with a deeper cut in the area between the thumb and the hand to improve the thumb’s flexibility.
Liposuction will drain away fatty tissue reducing the puffiness and improving the look of the hand.
It was a really weird sensation because I could feel my fingers wiggling inside my body,
The second operation, after a few months of recovery, will complete the hand by dividing the two separated sections into four fingers for cosmetic reconstruction.
Dr Boris Brandao from Santa Otilia Foundation Hospital in the neighbouring town of Orleans, was the orthopaedic surgeon who had the ingenious idea of salvaging Carlos’s hand after he was rushed in by ambulance following the grisly accident.
The specialist decided to transform Carlos’s tummy into a sterile incubator by inserting the hand through a 10cm incision into a cavity in the abdomen.
This prevented infection and necrosis from setting in, while allowing the limb to reconnect its blood supply and restore muscle and tissue.
Dr Brandao, who is also a dermatologist, said: “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.
“Then we sutured and sewed it into the abdomen so blood vessels could connect and flow through and turn the abdomen’s skin into the back of the hand while the muscle beneath would become part of the hand.”
Carlos, who is right-handed, says he experienced "terrible pain and discomfort" during the six weeks his hand was pinned inside his body.
He said: “The pain was unforgettable and unbearable. I struggled to sleep because I couldn’t turn on my side or lie on my front.
“Sometimes, I would explode with anger because I was so frustrated with being helpless.
"I was dependent on other people to help me with my personal hygiene, change my clothes, button up my shirt and put on my trousers.”
Carlos underwent two further operations in May 2016, the first to remove his hand from his paunch, 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.
While the next two pioneering surgeries could fundamentally transform his ability to use his hand, the surgical costs are beyond his family’s budget since he no longer works.
In a desperate bid to regain his independence and self-esteem, Carlos has launched a fundraising campaign.
He said: “I have been through a lot and struggled to make ends meet since the accident.
"Much of the surgery has been done with the kindness of Dr Brandao, as my employer has failed to support me.
“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.
"But I cannot get to the next stage without help.”
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