Friday, Jan. 8, 1999 | 11:23 a.m.
No matter how skilled the surgeon is or how sophisticated his surgical instruments, when it comes to reattaching a severed limb, a successful operation rests on the shoulders of one of God's little creatures.
The blood-sucking aquatic worm is what saved Julie St. John's right thumb. Three times a day, the shiny black beauty is placed on the tip of her thumb and does what it loves best -- it sucks blood.
In the process, it draws blood up through the palm of her hand and into the reattached thumb. Veins that had been interrupted from being severed suddenly come to life again.
"The leeches are the reason the thumb lived," Dr. William Zamboni, chief of the division of plastic surgery at University Medical Center, said. "The veins would get clogged up, if we didn't use the leeches. It takes five to seven days for a patient to re-establish the connection. The leeches get the flow going right."
St. John, 39, severed her thumb Dec. 30 while trying to load a friend's horse into a trailer. While trying to pull the horse forward from a rope on its neck, it suddenly jerked back and tore her thumb off.
"When I looked down, I had a thumb in the palm of my other hand," John said. "I wrapped a clean rag around it, and called 911."
St. John's boyfriend ended up driving her to a UMC Quick Care Center on Rancho Drive because they were on a ranch far out in the northwest part of Las Vegas. It would have taken too long for the ambulance to arrive. Zamboni successfully reattached the thumb in less than two hours.
When he and his speciality team saw St. John, she only had one tendon attached, the nerves and arteries were ripped out and the bone was completely broken off. And yet, she did the right thing by wrapping the thumb in a clean cloth and not putting it on ice.
Zamboni said ice would have freezer burned the thumb and killed the nerves. The best thing a person can go with a severed limb, the doctor said, is wrap it in moist gauze, put it in a plastic bag, place the bag in ice and rush to the hospital.
Zamboni started the replantation team at UMC in 1994. At the time, he was the only surgeon, but he has has since hired two more surgeons. With a speciality staff of nurses, the team performs about 30 reattachments a year.
The team can reattach an arm in from four to six hours, but multiple surgeries on fingers could take as long as 18 hours.
"A sharp clean cut has about a 90 percent success rate (for reattachment)," Zamboni said. If it is torn, the surgery is more difficult because the arteries and veins may be damaged too much. Then the success rate is about 50 percent.
On Thursday, the leech wasn't sucking too much on St. John's thumb. That's an indication that blood is flowing through the veins again, Zamboni said.
St. John's prognosis is excellent, Zamboni said. Her success rate is no longer a gamble.