Department of Surgery News | Renaissance School of Medicine at Stony Brook University

<BIG>HAND TEAM PERFORMS SUCCESSFUL REATTACHMENT OF MAN'S HANDS AFTER BOTH ARE NEARLY SEVERED IN WORK-RELATED ACCIDENT</BIG>

Patient Expected to Regain Partial Functional Use of Both Hands — Calls Himself "Lucky Man"

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Patient at press conference held on May 29, at 13 
days post-op, with surgical team (left to right), Drs. 
Mark Braunstein, Mark Epstein, Jason Ganz, and 
Lauren Grossman (click on photo to enlarge).</div>
</div>

On May 16, <a href="/surgery/people/faculty/dr-jason-c-ganz">Jason C. Ganz, MD</a>, assistant professor of surgery and member of our <a href="/surgery/divisions/plastic-reconstructive-surgery">Plastic and Reconstructive Surgery Division</a>, led a team of hand surgeons at Stony Brook University Hospital that successfully reattached the hands of a 53-year-old sheet metal worker from Staten Island, NY, after an accident nearly severed both of them.

Dr. Ganz, a plastic surgeon who specializes in microsurgical limb reattachment, performed the eight-hour surgery on Kenneth Klapak with Mark Epstein, MD, a plastic surgeon and former member of our faculty, assisted by Lauren Grossman, MD, and Mark Braunstein, MD, hand fellows at University Hospital.

The patient is expected to regain limited use of both hands, says Dr. Ganz.

The accident happened when Mr. Klapak was working at his metal shop and he fell forward onto a sheet metal bending machine, landing on his oustretched hands that were both almost completely severed when the machine fired.

Volunteers from North Babylon Fire Department responded to the scene of the accident in North Babylon, NY, and Mr. Klapak was airlifted via helicopter by Suffolk County Emergency Management Services paramedics to University Hospital, which is Suffolk County's only Level 1 Trauma Center.

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Since joining our faculty in 2008, Dr. Jason Ganz has made news on more than one occasion, performing rare and complicated limb reattachment surgery requiring the most sophisticated reconstructive microsurgical expertise.
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Dr. Ganz performed the reattachment of the left hand, which was severed in a tranverse angle across the top of the hand from the thumb to the wrist, and initiated reattachment of the right hand, which was severed laterally across the wrist.

He was then joined by Dr. Epstein, who completed the reattachment of the right hand while Dr. Ganz completed the left hand. All arteries and veins in both hands were severed except a single nerve in his right hand, as both hands dangled by tendons in the palms of his hands.

Working within a critical window of six hours or less to re-establish blood flow, the surgical team worked feverishly and meticulously to reconnect the veins, arteries and nerves. After the connections were complete, the skin tone in his hands changed to a pink color, indicating restored blood flow.

"Mr. Klapak is very lucky that he was brought to the right place immediately," Dr. Ganz says "He was transported from the emergency room to the operating room in less time than it took me to change into my scrubs."

Our surgeons used a cadaver nerve to replace a missing nerve that was completely crushed in the patient's left hand, and transplanted a tendon from his right forearm to his left hand as well. The patient is receiving additional skin grafts to further repair the damage. He will be receiving occupational and physical therapy to maximize his functional outcome.

<div class="callout">
This remarkable surgery, once inconceivable, is the result of a team effort involving not only surgeons but emergency medical technicians, anesthesiologists, nurses, and many others focused on saving the patient and his hands.
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"Some of the patient's flexor tendons were uninjured," Dr. Ganz explains, "which ultimately bodes very well for his hand function. Although he will have limited use of both hands, through physical therapy that may last a year or more, and the prospect of additional operations, his prognosis is good."

"This was obviously a team effort," adds Dr. Ganz. "Every nurse, every resident, and every anesthesiologist who took care of him that day made Stony Brook proud."

Mr. Klapak says that when he awoke on May 17 in his hospital room, he saw his hands and wiggled his fingers. "I thought, I hit the lotto," he says, with a tear in his eye, his voice breaking with emotion, as his wife, Kimberly, comforted him. "I was like, ‘Thank you God.' I am such a lucky man."

A guitar player for 45 years, Mr. Klapak says he is determined to play the instrument he loves again in the future. He is also looking forward to returning home with his wife, who has been with him around the clock. He praised the hospital staff and the expert care he has received at Stony Brook.

"I wouldn't trade it for the world," he says. "It's incredible. I have nothing but praise for the hospital."

Stony Brook surgeons also performed a similar surgery in 2005 on patient Arsenio Matias, at the time a 49-year-old plastic factory supervisor. That procedure —
the historic first simultaneous hand reattachment done in New York State (<a href="/sites/default/files/neofiles/POST-OP_Special-1_0.pdf" target="_blank">read more</a>) — was performed by a team led by <a href="/surgery/people/faculty/dr-alexander-b-dagum">Alexander B. Dagum, MD</a>, professor and interim chairman of surgery and chief of plastic and reconstructive surgery, and Lawrence Hurst, MD, professor and chairman of orthopaedics.

As the only Level 1 Trauma Center in Suffolk County, SBUH treats more than 90,000 Emergency Department patients annually, including approximately 2,000 trauma patients. SBUH receives transfers of complex, critically injured patients from community hospitals across Suffolk County. Stony Brook also provides online medical control for all volunteer ambulance agencies in the county.

Stony Brook EMS paramedics staff Suffolk Police helicopters under the medical control and direction of University Hospital, completing approximately 450 flights each year. Stony Brook's Trauma Center is one of four centers in New York State with inpatient survival rates for trauma patients that are significantly above the state average, according to the latest report from the New York State Trauma System.