A postman has undergone a pioneering operation to ‘rebuild’ his finger after it was savaged by a dog while he was delivering letters.
Plastic surgeons took a section of Royal Mail worker Alasdair Ross’s big toe and transplanted it on to his hand – replacing the missing top of his index finger.
The married 41-year-old from Bristol, who is also a part-time music teacher, chose to have the procedure as it would enable him to continue playing guitar.
Today, five months after the op, Alasdair is playing again and has regained nerve sensation in the tip of his new finger.
It is believed this is the first time the unusual procedure has been offered to a dog bite victim. The case was discussed at the British Association of Plastic, Reconstructive and Aesthetic Surgeons annual conference last week, where doctors heard there had been a 180 per cent rise in plastic surgery referrals for dog bite injuries.
Postman Alasdair Ross, 41, from Bristol, lost his finger after it was savaged by a dog while he making deliveries. Alasdair, who is also a part-time music teacher, chose to have the ‘pioneering’ procedure as it would enable him to continue playing guitar
It is believed this is the first time the unusual procedure has been offered to a dog bite victim.
It comes against a backdrop of rising incidence of dog attacks, which experts claim has been fuelled by the 3.2 million British households acquiring a pet since the start of the Covid pandemic.
Recalling the incident, which happened on a morning round in July, Alasdair says: ‘There are different types of letterboxes, and many have an internal flap.
‘This letterbox had one external flap and the inside was open. As I pushed a leaflet through with my left hand, I felt something clamping down on my index finger.’
Although he couldn’t see it, Alasdair immediately realised he was being attacked by a dog. ‘I started to kick the door and shout, and after about ten seconds, although it felt like longer, managed to wrench my hand free.
‘The shock hit hard – I saw how bad it was. The end of my finger had been gnawed off and I could see the bone.
‘I didn’t throw up or pass out, which I would have thought would be a natural reaction. And it didn’t hurt as much as it should have, perhaps because I’d also lost nerves.’
One of the household’s neighbours came to Alasdair’s aid and drove him to Bristol Royal Infirmary, where he was rushed in to surgery.
‘In theatre, the doctor cleaning up the wound said they could amputate the top of my finger, or I could wait and see a plastic surgeon to see if something could be done to reconstruct it,’ says Alasdair.
‘My recurring thought at this point was: will I ever be able to play guitar again?
‘I teach drums at a local secondary school, but mainly I’m a guitarist and I’ve played for 30 years. I’m in a band now. If it had been my right hand, then it wouldn’t have been so much of a problem, but you need the fingers of your left hand for the fretboard of the guitar. I said I’d give reconstructive surgery a go.’
Alasdair was bandaged and sent home with instructions to attend Southmead Hospital in Bristol a week later.
‘My wife Sophie was an absolute hero – I was on painkillers but my hand wouldn’t stop hurting.’
At his next appointment, plastic surgeon James Henderson explained the plan: to rebuild Alasdair’s finger with a transplant using his big toe.
‘I was unsure at first,’ says Alasdair. ‘I thought they were going to chop my toe off and stick it on to my finger, but that’s not what they actually do.’
During the complex operation, surgeons took an inch-square section of tissue from the inside of the big toe, along with blood vessels from another part of the foot
Mr Henderson, who performed the operation with his colleague Emily West, says: ‘Alasdair had lost the skin and pulp of his fingertip on the palm side and some bone.
‘Typically, you’d just shorten the finger to the level at which there was skin. These kinds of injuries are most commonly caused by power tools, and builders may be more concerned with getting back to work quickly, so opt to have the amputation. As Alasdair wanted to continue playing the guitar, we opted for a different solution.’
During the complex operation, which takes about two hours under general anaesthetic, surgeons take an inch-square section of tissue from the inside of the big toe, along with blood vessels from another part of the foot.
‘Unlike a skin graft, which is just skin, this is more like a transplant operation as we take the underlying tissues, nerves and blood vessels in order to rebuild the finger,’ explains Mr Henderson.
The surgeons attach the blood vessels and nerves from the transplanted tissue to the stump, and the skin is then stitched into place. The finger was bandaged and Alasdair spent a week in hospital recovering. ‘You have to keep an eye on it, as if there are blood clots or other problems the transplant won’t take,’ Mr Henderson says.
Alasdair continues: ‘The pain in my hand after the operation was excruciating – I thought I was going to lose my mind. But once they removed the bandages it subsided.
‘My finger was very swollen and bloody at first. Then sensation began to return – if you imagine when your hands get really cold, and then warm up – those uncomfortable pins and needles, that’s what it felt like.
‘Now it’s healed, my new finger is a few millimetres shorter but I have sensation in it. I was given exercises to do, to build up the strength of the finger, and I can do most things now, like do up zips and use the clutch in my car.
‘A few weeks ago, I started playing guitar again. It was a wonderful moment. I wasn’t quite as sharp as I was, but that means I can get better and it’s deeply encouraging.’