Surgical Teamwork Saves Child's Life
Microsurgery Techniques Spares Her Leg
March 20, 1999
The call came on February 26. A 20-month old, critically injured baby was being emergency airlifted by Mercy Flight from Corning Hospital to Children’s Hospital at Strong. A serious car accident had left Alecia Labar in shock with massive injuries that threatened her life and limb. Over the phone, a pediatrician from Corning detailed to George Drugas, M.D., her staff’s frantic efforts to resuscitate and stabilize the child.
Drugas said that the initial care she received at Corning Hospital saved Alecia’s life. "They recognized that if Alecia was to survive, she would have to be transferred to a pediatric trauma center," he said.
Once in Strong’s emergency room, the trauma team determined that Alecia had life-threatening injuries of the abdomen, pelvis, and left leg. Her left leg and pelvis were fractured and she had a large, deep laceration down to the bone behind her left knee and flank. A section of which supplies blood to the lower leg was crushed and a large clot had formed. So, while Alecia had a normal pulse in her thigh, she had no detectable pulses in her calf or foot.
Within 90 minutes of arriving at Strong, Alecia was in the operating room. First priority was her abdominal injuries. Bleeding from her spleen was controlled and a hole in her small intestine was repaired. A colostomy was fashioned to allow injuries to her large intestine and pelvis to heal.
Next, the operating team began working on Alecia’s extensive pelvic and rectal injuries. Pediatric orthopaedic surgeon David Weisman, M.D. was called in to care for her pelvic and left leg fractures.
Microsurgery Saves Leg
Examining her leg vessels through the laceration, surgeons identified a one-inch length of the artery that was damaged and clotted. In adults, this particular type of vessel injury is a difficult but reasonably straightforward problem to repair. In an infant or child, however, the small size of the vessel makes repair almost impossible. In Alecia’s case, the vessel was about the diameter of a strand of spaghetti – much too small for a normal vascular surgical procedure.
Microvascular and plastic surgeon Joseph Serletti, M.D. joined the operating room team. Serletti said that this was the first time at Strong that microsurgical techniques were used to repair an infant’s injured artery in an effort to save a leg.
"It was obvious that we could not simply remove the clot and seal Alecia’s artery back together," Serletti said. "We would have to borrow a segment of vein from the skin flap in the back of her leg and use it to patch the damaged artery. If we couldn’t make that work, amputation may have been necessary." The sutures used to sew Alecia’s vessels are finer than a strand of hair.
After nearly two hours, Serletti released the surgical clamps, and the surgical team watched as Alecia’s foot turned pink. Muscle and skin were stretched to cover the wound on the back of Alecia’s knee.
After ten and a half hours in the operating room, Alecia was transferred to the Pediatric ICU to begin her recovery. Over the next several days, Alecia would return to the operating room three more times.
Alecia will be discharged on March 21. It may take 5 to 6 years to assess her full recovery but her doctors are confident that she will be able to walk again soon.
Alecia’s family members have posted an around-the-clock vigil at her bedside. Alecia’s mother, Becky Peterson, feels that her recovery has been nothing short of miraculous. "She certainly has touched the lives of a lot of people," she said.
A couple of weeks ago, Alecia received some hometown visitors: a group of emergency room nurses from Corning Hospital. "They simply had to see for themselves that she had survived," said Alecia’s grandmother Lynda Peterson.
"We couldn’t be more grateful to the staff at Strong," she added. "They truly are a Dream Team."