Postie Alasdair’s finger rebuilt after dog attack by using part of his big toe: Pioneering op is the first of its kind as plastic surgeons warn of 180 per cent rise in referrals from dog bites

A postman has undergone groundbreaking surgery to 'reconstruct' his finger after it was destroyed by a dog while delivering letters.

Plastic surgeons took part of Royal Mail employee Alasdair Ross's big toe and transplanted it into 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, opted for the procedure because it would allow him to continue playing the guitar.

Today, five months after surgery, Alasdair is playing again and has nerve sensation in the tip of his new finger again.

This is believed to be the first time this unusual procedure has been offered to a dog bite victim. The case was discussed last week at the annual conference of the British Association of Plastic, Reconstructive and Aesthetic Surgeons, where doctors heard that referrals to plastic surgery due to dog bites had risen by 180 percent.

This is believed to be the first time this unusual procedure has been offered to a dog bite victim.

It comes against the backdrop of a rising number of dog attacks, which experts claim have been fueled by 3.2 million British households acquiring a pet since the start of the Covid pandemic.

Recalling the incident, which took place during a morning run in July, Alasdair says: 'There are different types of letterboxes, and many of them have an internal flap.

'This mailbox had one external flap and the inside was open. As I pushed a leaflet through with my left hand, I felt something clamped around my index finger.'

Although he could not see it, Alasdair immediately realized that he was being attacked by a dog. 'I started kicking the door and shouting, and after about ten seconds, although it seemed longer, I managed to rip my hand free.

'The shock was hard, I saw how bad it was. The end of my finger was gnawed off and I could see the bone.

'I didn't throw up or pass out, which I thought would be a natural reaction. And it didn't hurt as much as it should have, maybe because I was losing nerve too.”

One of the household's neighbors came to Alasdair's aid and took him to Bristol Royal Infirmary, where he was rushed into surgery.

“At the cinema, the doctor who cleaned up the wound said they could amputate the tip of my finger, or I could wait and go to a plastic surgeon to see if anything could be done to reconstruct the wound,” says Alasdair.

'My recurring thought at this point was: Will I ever be able to play guitar again?

'I teach drums at a local high school, but I'm mainly a guitarist and have been playing for 30 years. I'm in a band now. If it had been my right hand it wouldn't have been such a problem, but the guitar fingerboard requires the fingers of your left hand. I said I would try reconstructive surgery.”

Alasdair was bandaged and sent home with instructions to go to Southmead Hospital in Bristol a week later.

'My wife Sophie was an absolute hero. I took painkillers, but my hand kept hurting.'

At his next appointment, plastic surgeon James Henderson explained the plan: rebuild Alasdair's finger with a transplant using his big toe.

“At first I was unsure,” says Alasdair. “I thought they were going to cut off my toe and stick it on my finger, but that's not what they actually do.”

During the complex operation, surgeons took a one-square-centimeter sample of tissue from the inside of the big toe, along with blood vessels from another part of the foot.

Mr Henderson, who carried out the operation with his colleague Emily West, said: 'Alasdair had lost the skin and pulp of his fingertip on the palm side and some bone.

'Normally you just shortened the finger to the level where there was skin. These types of injuries are usually caused by power tools, and builders may be more concerned about getting back to work quickly, so opt for the amputation. Because Alasdair wanted to continue playing guitar, we opted for a different solution.'

During the complex operation, which takes about two hours under general anesthesia, surgeons take a square 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 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 sutured in 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 that the transplant can't handle,” says Mr. Henderson.

Alasdair continues: 'The pain in my hand after the operation was unbearable – I thought I was going crazy. But as soon as they removed the bandage, it disappeared.

'My finger was very swollen and bloody at first. Then the feeling started to come back – when you imagine your hands getting really cold and then warming up again – that uncomfortable tingling, that's what it felt like.

'It is now healed, my new finger is a few millimeters shorter but I do have feeling in it. I was given exercises to build finger strength, and I can now do most things, like closing zippers and using the clutch in my car.

'A few weeks ago I started playing guitar again. It was a beautiful moment. I wasn't as sharp as before, but that means I can get better and that's very encouraging.”