Feature Stories

New Hand New Life / Plastic surgery gives a preschooler a chance at a normal life

By Melissa Hoon / Photography: Larissa Bahr Click any image to see slideshow.

Burn victim Húng Ðung, 5, has his hand evaluated by a nurse from Project Vietnam Foundation (PVNF), a medical mission organized in Orange County, Calif.
Burn victim Húng Ðung, 5, has his hand evaluated by a nurse from Project Vietnam Foundation (PVNF), a medical mission organized in Orange County, Calif.

Ðăng Thi Ðung gazes at her 5-year-old son’s burned and deformed hand, wishing he could be able to write his name. She cradled him on the back of a speeding red motorbike as her husband, Son Văn Triêu, drove for four hours through narrow winding roads and muddy mountain passes to meet with a New York surgeon in the province of Bac Kan, Vietnam.

Four years ago, as he was learning to walk, Húng Qúy Triêu trampled across the dirt floor of his family’s one room hut and fell into a pile of burning coals. He used his hands to break his fall and burned his right hand, causing it to morph into a deformity that resembled a claw.
“Húng cannot write and is not as normal as other kids,” Ðăng says through a translator. “I would be very happy if he could have a normal hand and a good future.”

Surgery prepA PVNF nurse rubs iodine on Húng’s hand in preparation for surgery.

After driving four hours, Son, 27, and Ðăng, 24, wait in a tiny hospital hallway packed with dozens of patients for Húng to be prescreened before his surgery the next day. Son and Ðăng, who spend their days with their backs hunched with beads of sweat dotting their foreheads as they cultivate rice for $3.75 per month, dressed Húng in his finest clothes to see the American specialist. Húng sat quietly in his mother’s lap, wearing a red silk suit lined with camel-colored faux fur and a striped coffee-toned beanie that kept him warm under the moist gray skies of Northern Vietnam.

Húng looks at his burned hand, which will not be the same after surgery.

Húng’s wide brown eyes carefully scan his surroundings. He smiles docilely as his blood pressure and temperature are taken. R. Michael Koch, M.D., the New York plastic surgeon, evaluates Húng’s claw-like scar tissue. Húng is playful and laughs when the nurses and Dr. Koch tickle him.

A communist party official told Son and Ðăng that Húng might be able to have his hand repaired by an American doctor. They walk their son up two flights of dusty hospital stairs to a 10-by-6-foot room. Húng is energetic, racing across the room and tugging at Son’s pant leg, as Ðăng rolls a thin bamboo mattress across a twin metal bed frame. They will stay the night in this ward that is crowded with other patients and their families. In Vietnam, family members take on traditional nursing tasks, such as feeding patients, changing bed pans and administering medicine.

* * *

Skin graftDr. Koch uses both hands to stitch the skin graft during the three hour surgery. Húng’s joints and tendons function normally, but his skin is limited.

It’s 7 o’clock the morning of the surgery. Wearing clothes from the previous day, Ðăng clutches Húng to her breast and lightly pushes his dark hair back from his forehead as they wait on a rickety bench near the outdoor corridor of the operating room (O.R.). Dr. Koch, part of a medical mission organized in Orange County, Calif., and his nursing team prepare the O.R. just 30 feet from where Húng and his mother wait. They unload neatly packed boxes from the United States, pulling out shiny syringes, scalpels and medical tape. Outside, Húng kicks and screams as Ðăng tries to soothe him. The anesthesiologist points a syringe upward, shooting a clear strand of liquid into the air. He gently gives Húng a shot. Within minutes, the boy’s wide eyes flutter and his motion grows slower until he is asleep.

Skin graftR. Michael Koch, M.D., a PVNF surgeon from New York, removes skin from Húng’s groin.

Nurses sterilize utensils for the three-hour surgery. The anesthesiologist carries a limp Húng and lies him on the operating table. At 8:15 a.m., Dr. Koch uses a black felt pen to carefully draw a half-moon shape just above Húng’s groin area where skin will be removed for a graft. A thin scapula makes an incision along the half-moon. He peels Húng’s skin away slowly from his muscles, then carefully rolls the skin like a cigarette and puts it aside to be grafted.

Just after 9 a.m., Dr. Koch begins removing scar tissue from Húng’s hand. Skin crackles and sizzles as he cauterizes areas where blood leaks. Húng’s joints and tendons function normally, but his skin is limited, scarred and inelastic. After Dr. Koch removes the scar tissue, he unrolls the removed groin skin and cuts precisely. The small shapes he makes of the skin fit the gaping blood-red holes on Húng’s hand like pieces to a puzzle. Dr. Koch sews the skin puzzle pieces together, using both hands to stitch with ease.

Ðăng sits in the hallway looking like she might cry. She occasionally paces back and forth on the damp concrete pavement, as her frequent stares penetrate the hospital’s double glass doors. She expects Dr. Koch to walk through the doors with Húng and his newly functioning hand at any moment.

* * *

Skin graftA skin graft surgery was performed in attempt to give Húng’s hand full range of motion. Skin from his groin replaced inelastic scar tissue on his hand.

Dr. Koch carefully stitches the last bloody hole on Húng’s hand at 10:58 a.m. This is the first of many surgeries Húng will need for his hand to function normally. His parents’ farming income will not be enough for him to receive another surgery. By practicing physical therapy at home with his parents, however, Húng is likely to gain almost full range of motion in his hand after his free firstsurgery.

Dr. Koch paints a thick gray paste across Húng’s hand and arm to set a cast. He wraps Húng’s hand slowly in layers of white fluffy gauze. A nurse carries Húng across the hall to a cramped recovery room with metal frame beds only four feet from one another. Nurses check Húng’s temperature and take his blood pressure. They prop a stuffed animal underneath him so that his arm is raised in order for the skin graft to fuse successfully.

Ðăng sits by Húng’s side at the edge of the bed and brushes his bangs away from his closed eyes. Through a soft smile, she talks to him soothingly, hoping he’ll awake to her familiar voice. She stares at his bandaged hand. Nervous but joyous tears rush down her smooth tan cheekbones. It’s as if she sees through the thick layers of gauze, seeing Húng’s hand looking and functioning almost normally.

“I’m worried because I don’t know yet how Húng will be when he wakes up,” she says. She speaks softly but innate concern lingers in each word.

Húng’s eyelids fly open at 11:35 a.m. His deep chestnut eyes are wide and worried. He screams and cries in confusion and pain. Ðăng rocks Húng as she drapes him with a small pink blanket. A nurse smiles and gives Húng a coloring book and crayons, which Ðăng politely sets aside. The nurse folds a blue towel into a triangle and safety pins it into a makeshift sling to hold Húng’s arm above his chest, over his heart. He stops crying and is carried to the room where he stayed the night before. He will stay there with his parents for the next two nights.

* * *

Just after 8 o’clock the following morning, Dr. Koch visits Húng for a post-operation evaluation. He gives the family antibiotics and pain medication to administer to Húng. As Dr. Koch approaches Húng, the boy remains in pain, but is silent and stoic. Suddenly, Húng’s eyes pop and a smile shoots across his face as Dr. Koch hands him a yellow remote control car.

As a nurse speaks to Húng’s parents, Húng drives his new car around the crowded recovery room, weaving it through nurses’ feet. He is back to his playful self. He seems to forget he’s in a hospital as he steers his new toy with his free hand. Soon, the nurses say, he’ll drive the toy car with both hands.

Skin graftHúng drives his new toy car with his free hand in the recovery room.
Húng smiles the next morning post-opHúng smiles the next morning post-op.