Hand and Microvascular Surgery

The Department of Hand and Microvascular Surgery at Dongguan People's Hospital is a first-level clinical discipline that integrates clinical diagnosis and treatment, teaching and training, and research and innovation. It is also Dongguan's largest specialised hand and microvascular surgery service, with the most complete equipment and the strongest technical capability, and it enjoys wide influence and a good popular reputation in Dongguan and the surrounding area.

The department has a rich history. Founded in June 1999, it was one of the earlier microsurgery and hand surgery specialty departments established in Guangdong Province. At the time of its founding the department brought in a high-level professional and technical team and was the first to carry out core, technically demanding procedures such as replantation of severed fingers, reconstruction of the thumb and fingers, pedicled abdominal flaps, pedicled dorsal interosseous flaps, free anterolateral thigh flaps and musculocutaneous flap repair. Its superb medical skills quickly won the recognition of patients and established its leading position as a regional specialty.

After more than 20 years of development, the department's techniques have continued to advance and its scope of diagnosis and treatment has expanded further; it was formally renamed the Department of Hand and Microvascular Surgery, and it was the first in Dongguan to explore and carry out a number of advanced hand surgery diagnostic and therapeutic techniques, with its overall standard of treatment steadily remaining among the region's leaders.

The department has a specialised team of excellent style and consummate skill, including 1 Chief Physician, 4 Associate Chief Physicians, 8 Attending Physicians and 1 Resident Physician. Members of the specialist team have long worked at the clinical front line and have accumulated rich clinical experience, and are accomplished in managing all kinds of difficult and complex microsurgical cases of the hands and feet. The nursing team consists of 1 Associate Chief Nurse, 9 “zhuguan hushi” nurses, 3 nurses and 2 specialist nurses, forming a rationally structured nursing team of outstanding professional ability that specialises in perioperative nursing in hand and foot surgery, wound repair nursing and postoperative rehabilitation guidance, effectively improving the quality of patients' postoperative recovery.

The department runs both specialist and expert outpatient clinics at the Honglou Outpatient Department of the Honglou campus and at the Puji Outpatient Department of the Puji campus, providing professional diagnostic and treatment services to the people of Dongguan.

Specialised techniques and innovation

In recent years the department has empowered clinical work through technical innovation, continuously introducing and developing cutting-edge new techniques and new projects. A number of these techniques have filled regional technical gaps and are now performed comprehensively, routinely and at a mature level:

1. Reconstruction of the finger (toe) web with a double-wing flap and separation of the fingers (toes) 2. Transverse tibial bone transport 3. Wrist arthroscopic carpal tunnel release 4. Artificial metacarpophalangeal and interphalangeal joint replacement 5. Guangdong Province appropriate technology — small-incision minimally invasive surgery for carpal tunnel syndrome

Specialist nursing has been upgraded in step with this innovation. The department has maturely implemented a modified ankle joint functional training technique and a modified local oxygen therapy technique, which have greatly improved the efficiency of wound healing and the results of limb functional recovery, and markedly improved patients' postoperative quality of life.

Equipment and hardware strengths

The department is equipped with a full set of specialised diagnostic and therapeutic equipment, including a wrist arthroscope, a high-magnification binocular operating microscope, laser therapy devices, traditional Chinese medicine physiotherapy equipment, pneumatic compression therapy equipment and other precision instruments. These allow all kinds of high-precision nerve, microvascular and flap repair procedures to be performed accurately and safely. The department has also completed a supporting postoperative rehabilitation and physiotherapy system, achieving integrated diagnosis and treatment of “precise surgery plus systematic rehabilitation”.

Research and teaching capability

In research and teaching, the department adheres to the coordinated development of clinical work with research and teaching. In recent years it has obtained approval for 4 research projects at provincial and municipal level and has published more than 30 papers in core journals in China and abroad. It undertakes year-round teaching of regional specialist physicians and training of advanced trainees, and each year trains and supplies more than 10 specialist physicians for the Dongguan area, continuously supporting the development of regional hand and foot surgery professionals.

Main scope of diagnosis and treatment

1. Emergency treatment of all types of limb trauma: ruptured nerves, vessels and tendons, hand fractures, and various occupational, traffic accident and accidental open injuries. 2. Replantation and reconstruction of severed limbs (digits): replantation of severed fingers (toes), limbs and palms, and reconstruction of the thumb, fingers and nails by toe transfer. 3. Limb wound repair and functional reconstruction: repair with various flaps, muscle flaps and bone flaps (free or pedicled); functional reconstruction for nerve injury or paralysis of the limbs; scar release of the limbs; and release of ankylosis and functional reconstruction by joint replacement after ankylosis or stiffness of the joints of the hand. 4. Common diseases of the hand: various masses of the limbs, for example nerve (sheath) tumours, ganglion cysts, lipomas, chondromas, haemangiomas and various types of tenosynovitis, as well as other masses and inflammatory diseases of the hands and feet. 5. Peripheral nerve entrapment diseases of the limbs: numbness, pain and weakness of the limbs caused by carpal tunnel syndrome, cubital tunnel syndrome, ulnar tunnel (Guyon's canal) syndrome, common peroneal nerve entrapment and similar conditions. 6. Correction of congenital hand and foot deformities: correction of polydactyly of the fingers (toes), correction of syndactyly of the fingers (toes), release of annular constriction bands of the limbs and similar procedures. 7. Refractory wounds and infectious diseases: diabetic foot (hand) disease, chronic osteomyelitis, pressure ulcers, and various refractory chronic ulcers of the limbs (infectious, neoplastic, traumatic and vascular ulcers). 8. Lower limb vascular disease: minimally invasive combined endovascular and extravascular surgery for varicosity of the great saphenous vein.