Berk Altınelli, a 29-year-old engineer who has been working abroad since 2014, experienced an accident at sea about two months ago, resulting in the severing of his right hand index finger at the middle joint. After the initial panic, thanks to his professional training, he managed to locate his severed finger with the help of his colleagues and wrapped it in ice. Transported by helicopter to one of Malta’s largest public hospitals, doctors told Berk Altınelli that his finger could not be reattached, advised him not to keep it, and even suggested discarding it.

The young engineer, unwilling to give up on his finger, contacted his dentist uncle living in Istanbul and inquired whether the surgery could be performed in Turkey. Thanks to the efforts of his mother, Alev Altınelli, and his uncle, the family reached out to Prof. Dr. Mehmet Veli Karaaltın, a reconstructive and microsurgery specialist. Prof. Dr. Karaaltın stated that typically, severed limbs need to be reattached within a maximum of eight to nine hours but said, "We are taking a risk, but I will try."

The dramatic Malta-to-Turkey finger-saving operation, which took nearly 24 hours, began with this statement and resulted in the young engineer’s finger being successfully reattached, making it a candidate for medical literature.

Altınelli recounted the day: "My index finger was severed at the joint. I was urgently transported by helicopter to the hospital. Doctors in Malta clearly stated that my finger could not be reattached and that I would never be able to use it again. Desperately, I called my uncle to ask if there was a doctor in Turkey who could perform the surgery. During this time, I was very scared. I needed to find a plane ticket, and there was a pandemic. But I did not give up. When I learned that the surgery could be performed in Turkey, my hope increased even more."

The engineer, who managed to find a plane ticket for the next morning despite the difficulties, continued: "In the hotel room, my severed finger in the ice pack began waiting for the flight time. I needed to reach the hospital for surgery within a maximum of 19 hours because they said the tissue would die. However, due to the pandemic-related challenges, it even took me longer than 19 hours to get to Istanbul and undergo the surgery. The accident happened around 7 p.m., and the flight was at around 9:30 the next morning."

The following morning, Altınelli boarded the plane with his severed finger in the ice pack he had placed in his backpack. Reflecting on his experience, he offered this advice: “When I landed, an ambulance was already arranged, and I was taken directly to the hospital from the airport. I was admitted for surgery in the evening. Thanks to my surgeons, my finger is now in place. We will start physical therapy, God willing. ‘Entrust me to Turkish doctors’—this is true. The doctors there told me to throw away my finger, saying it was pointless to keep it. But I did not lose hope. Thank God, my finger is in place now, and I am very happy. In cases of limb loss, the first thing we need to do, and I urge everyone to keep this in mind, is to put it in ice as soon as possible. The chance of the tissue surviving is much higher when preserved in ice. The possibility of reattachment increases. I am the best example of this.”

Prof. Dr. Karaaltın, who performed the surgery, described the operation: “As soon as I heard about the time, I told my colleague, who is also a close relative of the patient, that the time limit of eight to ten hours had been significantly exceeded and might even extend to 24 hours. I said, ‘We will try; we will do our best.’ Some things are irreparable, and the loss of a mechanical engineer’s working ability is a serious loss—for the country, for himself, and for his family. According to textbook knowledge, the likelihood of success after such a duration is almost nonexistent. I took a risk because if we failed, it would have been a surgical failure for me, even if the family was understanding. But considering the patient’s age and the risks of the potential loss, I decided to give it a try. The finger’s blood flow took up to 25 hours. I repaired the vessel, opened the clamp, and paused to see if blood would reach the finger, waiting with great excitement. I was very happy when the finger started to receive blood after opening the clamp.”

Prof. Dr. Karaaltın noted that tissue death in limb loss is due to ischemia, or lack of blood flow. He said, “The finger is somewhat more resilient in this regard. It contains almost no muscle tissue, only connective tissue, skin, and bone. That was our only luck. The surgery we performed was of a nature that will be recorded in the literature.”

Emphasizing Turkey’s strong position in this field, Prof. Dr. Karaaltın concluded: “Before surgeries, I usually take off my watch and put it on the table. I forget the time. Microsurgery is like that. These are surgeries I enter with great excitement because you are saving a limb. Honestly, I didn’t check the time, but it was probably around 11 hours. In terms of microsurgery, I believe Turkey is in the best position in Europe. Today’s young colleagues are less interested in microsurgery because it is very demanding and exhausting. But I urge some of them to enter this field because the country needs it.”

Source: https://www.diken.com.tr/kopan-parmagini-maltadan-cantada-getirip-diktirdi/