Blood Vessel Repair Surgery in Pune: Microsurgical Repair of Injured Vessels

What is blood vessel repair?

Arteries carry blood to the tissues; veins carry it back. A cut from glass or a knife, a crush or a machine injury can divide them. Large vessels in the arm or leg are usually repaired by vascular or trauma surgeons. The small vessels of the hand, fingers and face are often repaired by plastic or hand surgeons using microsurgery, which means working under an operating microscope with instruments and stitches designed for vessels only one to two millimetres wide.

The same microsurgical skills are used to:

• reattach fingers or parts of the hand that have been cut off;
• move tissue (free flaps) from one part of the body to another and reconnect its blood supply, for example in cancer reconstruction;
• create access for dialysis; see AV fistula surgery.

How is a vessel injury assessed?

Signs of an arterial injury include bright red, spurting bleeding, a pale or white finger, a cold hand, slow return of colour after pressing the nail, and an expanding swelling. Veins bleed more steadily, with darker blood.

The surgeon checks the colour, warmth and capillary refill of each finger, tests nerves and tendons, and uses a handheld Doppler or other scan if needed. Many hand wounds that cut an artery also cut the nerve running beside it.

What are the treatment options?

Option	Suits	Points to consider
Pressure and observation	Minor bleeding with good circulation beyond	Common for small veins
Tying off the vessel	One of two arteries cut, with good circulation from the other	Quick; some surgeons repair both where possible
Direct microsurgical repair	Clean cuts with healthy ends	Restores flow; needs a microscope
Vein graft	Missing or crushed segments	A small vein from the forearm or foot bridges the gap
Replantation	Cut-off fingers or hand in selected cases	Long operation; not always possible

Associated nerve and tendon injuries are repaired at the same time; see nerve repair surgery and tendon repair surgery.

How is microsurgical vessel repair performed?

1. Anaesthesia: a regional block or general anaesthesia.
2. Exploration: the wound is cleaned and extended to find healthy vessel ends.
3. Preparation: damaged vessel is trimmed back to healthy wall under the microscope.
4. Repair: the ends are joined with very fine stitches, or a vein graft is inserted.
5. Checking flow: the surgeon confirms that blood is flowing through the repair and the finger has turned pink.
6. Protection: a bulky dressing and splint keep the area still and warm.

How should you prepare, and what should you ask?

This is usually emergency surgery, so preparation is brief:

• Tell the team about blood thinners, smoking and medical conditions.
• Do not eat or drink once surgery is likely.
• If a part has been cut off, follow the cooling advice for the amputated part and bring it with you.

Questions to ask:

• Which structures are injured?
• Is the blood supply to my finger or hand safe?
• How will the repair be monitored after surgery?
• What therapy will I need?

What is recovery like?

Time	What to expect for most patients
First 3-5 days	Close monitoring of colour and warmth; hand kept warm and raised as advised
Weeks 1-2	Wound checks; stitches removed
Weeks 2-6	Hand therapy for associated tendon or nerve repairs
Months	Recovery of feeling and strength, depending on nerve injuries

What are the risks?

• Clotting of the repair, which may need urgent re-operation.
• Loss of the finger or tissue if blood flow cannot be restored.
• Infection.
• Cold intolerance of the finger.
• Stiffness and weakness from associated injuries.

Contact the team immediately if a repaired finger becomes pale, blue, cold or swollen.

What results can you expect?

When blood flow is restored, the tissue usually survives, and the long-term function depends mainly on the nerve, tendon and bone injuries that came with it.

What happens if a vessel injury is missed?

It depends on which vessel is cut and whether enough blood still reaches the tissue beyond. A cut vein, or one of a finger’s two arteries, may simply seal off without lasting harm. When the main supply to a finger or the hand is lost, the tissue beyond can die, and the time available to restore flow is short. Partial injuries can be missed because the bleeding stops; the vessel may later form a pulsating swelling (false aneurysm) or block with clot, leaving a cold, painful finger. Pressure and observation are reasonable only when examination, and a Doppler check if needed, confirm good circulation beyond the wound.

Common myths about blood vessel injuries

• “Once the bleeding stops, the injury is fine.” A cut artery can stop bleeding as it clots or goes into spasm while the finger still lacks blood.
• “Tying a thread tightly around the finger is the right first aid.” A tight band can cut off the remaining circulation, so firm pressure on the wound with a clean cloth is safer.
• “Turmeric or coffee powder will seal a cut vessel.” Powders do not repair a vessel, and they contaminate the wound.
• “Finger blood vessels are too small to repair.” Vessels of one to two millimetres can be joined with an operating microscope and very fine stitches.

What affects the cost of blood vessel repair surgery in Pune?

• Number of vessels and associated injuries.
• Use of vein grafts and length of surgery.
• Hospital stay and monitoring.
• Hand therapy and follow-up visits.

Treatment after an injury is usually covered by health or accident insurance, subject to your policy.