Click on any picture to see it at a larger size.
（点击看大图-小枯）
This is my arm during the 2nd surgery, 36 hours after the bite. You can see how unhealthy all the tissue is.
This is my hand, also during the 2nd surgery. There is a lot of dead tissue in the palm.
This
is my hand during the 5th surgery, on Day 12. As you can see, there is
still a substantial amount of dead tissue in the palm, but noticable
progress on cleaning it out has been made. The surgeons have started
the long process of closing the hand, using staples and rubber bands.
This
is my hand during the 8th surgery, on Day 23. You can see the healthy
muscle tissue in the arm. One tendon is exposed in my hand, which the
surgeons are worried might be a problem for the skin graft that is to
be performed in the next week. This is because skin grafts don't attach
well to tendons, but they attach very well to muscle and other soft
tissue.
This
is my arm during the 9th surgery, on Day 26. This is the last surgery
before the skin graft, so the surgeons want to close up the arm as much
as possible. You can see the skin being pulled closed by staples and
rubber bands.
This
is my hand, also during the 9th surgery. You can see that the exposed
tendon has been partially covered since the last surgery, which the
surgeons were very happy with. To accomplish this, the surgeons pulled
my thumb in during the surgery, and used the extra skin this gave them
to further close the palm, and the plan was to do a follow-up surgery
some time later to bring the thumb back out in some way. You can also
see the stiches on the bottom of my palm, which have now been put in
further up into my palm, also helping to cover part of the exposed
tendon.
This
is my arm during the 10th surgery, on Day 30. This surgery was the one
in which the skin grafting was performed, and you can see the fresh
skin that has been stapled to my arm. This skin was taken from my
thigh. Holes were put in it in order to allow blood to flow onto the
skin so it could attach to the tissue beneath it.
This is my hand, also during the 10th surgery. The skin graft in the palm was taken from my inner thigh/groin area.
This
is the skin graft on my arm after 5 days, on Day 35, right before I was
released from the hospital. You can see the holes have begun to fill in
with tissue and the edges of the graft are starting to attach to the
surrounding skin.
This
is the graft in my hand, also after 5 days, on Day 35. It is difficult
to see in the picutre, but there is a small hole at the very bottom of
the graft where is did not "take", which is what surgeons call it when
a graft attaches to the existing skin in an area. A small amount of the
graft not taking is to be expected, and it is not a big deal; the hand
just needed to stay wrapped to prevent infection for a week after this
until the hole filled in.
This
is my arm 5 months after the graph, in December 2002. You can see that
the holes that were in the graft are completely filled and the graft
blends in with the surrouding skin much better.
This
is my hand, also in December 2002 after 5 months. Note that although
the skin graft in the palm is fully healed, physical therapy has done
very little to bring out my thumb from its position, a position which
made it very difficult to use my hand for pinching and other actions
involving the thumb. This led us to schedule the follow-up surgery to
bring the thumb out to its correct position, and after finding out
about all the possible procedures and locations for the surgery, we
made the decision to have a scapular vascular flap performed by the #1
vascular flap surgeon in the country at Duke University Medical Center.
This
is my hand 3 days after the vascular flap surgery in the Duke Hospital.
The surgeons took that chunk of skin and muscle from my back, attached
its artery and vein using microsurgery, and then stitched it to my arm.
During this surgery, the old skin graft in the palm of my hand was
taken out. The surgery took 6 hours, which included a tenolysis, a
process where they cleaned out the scar tissue around my tendons,
improving the range of motion of my fingers. This procedure also meant
that I needed to do very intense physical therapy for approximately 2
weeks following it so that scar tissue did not grow back around my
tendons.
You
can see a small section of black tissue below the flap; this is just
where there was some blood clotting, causing the tissue to die, and
over the following month new tissue grew to replace the dead tissue,
leaving no permanent damage.
This
is a picture of my arm taken in April 2004, 22 months after the bite
and 15 months after the vascular flap was performed at Duke. It is
clear that all the problems have been overcome, and both the skin graft
and the flap look much more a natural part of the arm than before.
Although it cannot be seen from the picture, my fingers and wrist now
have full range of motion.
想了解更多的点击Click to read the story of my snake bite
