Plastic Surgeon REACTS to JOHNNY DEPP FINGER AMPUTATION in Amber Heard Defamation Trial!

Welcome back to ARONOWITZLAND with Dr. Joel Aronowitz, Plastic & Reconstructive surgeon in Los Angeles. Dr. Aronowitz has been one of the most reputable plastic and reconstructive surgeons of Beverly Hills, California for the past 30 years. He is also the medical director of the Tower Wound Care Centers in Beverly Hills, Santa Monica, Culver City, Encino, Pasadena and Lynwood.
In this episode, you will join Dr. Aronowitz as he explores the medical point of view in the Johnny Depp VS Amber Heard defamation trial- specifically Johnny's unfortunate finger incident!
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[@mannys9130]

If I might add 2 things to the ending's advice section of traumatic amputations: 1.) If the bleeding is heavy, don't hesitate to use a tourniquet. The latest research shows that tourniquets can actually be left on for a couple hours without any lasting permanent damage as a result of the limb's hypoxia and acidification. If the person is bleeding enough that you look at the puddle and say "oOoOO boy that's a lot of blood" chances are they would benefit from a tourniquet. If it's not enough to make a puddle, you can do without one. If the would is spurting or spraying blood, that's arterial and you should TQ it because that will pump a lot of volume under pressure pretty quickly, even a small artery. Make sure you can tell EMS or ER doctors exactly what time it was put on though, so write it down somewhere preferably on the TQ itself or on the patient's body in ink that won't rub or wash off. For a finger, probably no need unless the person is on blood thinners or aspirin therapy. A simple rubber band will work great on a finger. In fact, when I get cuts or scrapes on my hand or fingers, I use a rubber band or ace bandage to tourniquet the blood flow so I can clean the wound well, see how deep it is, and effectively get a bandaid to stick well or to use cyanoacrylate to seal the wound edges without blood washing it away constantly. Actively bleeding cuts make all of those things difficult. It only takes 5 minutes or so to do that, then I remove it. If the TQ has been on for a few minutes, don't remove it after that. Rebound bleeding will be worse than it was originally. Let the hospital remove it. Elevate the body part and apply pressure if a TQ is not needed or can't physically be applied due to the nature and anatomy of the injury. 2.) The severed piece of the patient's body should always be found if possible and sent with them to the hospital as the doctor told us here in the video. If you can, use a cooler or insulated mug with some ice in it to bring down the temperature of the amputated tissue or structure. You could even wrap the piece in a cloth, get a Ziploc bag and a big towel, rip off a piece of aluminum foil, make an ice bed in the bag, put the cloth-wrapped piece on the ice, seal the bag, and then wrap the bag up in the towel and then wrap the towel inside of the foil. The metal acts as a radiant barrier to keep the heat out, and the bigger towel keeps the aluminum from acting as a heat sink which would be defeating the purpose. Be very careful with this though because you can harm the piece even more with ice if you aren't careful! Wrap the piece in clean cloth or sterile gauze so there is a good barrier between it and the ice. Make sure that the ice is *NOT* in direct contact with the amputated part. Ice on bare skin will give someone frost bite and can kill the tissue (cryotherapy for warts is a great example, or toes and ears and nose tip frost bite and necrosis). That's WITH blood flow and perfusion of nice warm blood carrying heat to the cells to keep them from freezing. An amputated body part or tissue has no blood flow. It'll freeze much more easily and quickly. All we want to do is bring down the temperature of the tissue to decrease the cells' metabolic rate thereby decreasing their need for oxygen and decreasing their need for CO2 removal. Compared to body temp or room temp tissue, a cooled specimen is going to survive longer so that it is still viable and re-attachable for a longer time period later at the hospital. You want the tissue to be refrigerator cold; absolutely NOT near freezing. On both surfaces, respect the wound margins and don't try to remove any degloved or dangling tissue. Wrap the piece up in clean padding material, put it on ice in an insulated cooler or coffee cup, TQ the stump if needed, write the application time of the TQ, and go to the hospital right away. Poor Johnny. I'm so happy the truth is coming out now.

[@downhomesunset]

Would it be good to wrap the amputated structure in gauze and then stretch wrap before the ice so it doesn’t come in contact with the ice?

[@RealPlasticsDoc]

this is an excellent comment, thank you. Your point 2 is absolutely correct. Your first point however I have a couple of comments on. I do not recommend a cyanoacrylic ie dermabond for hemostasis of any kind. You should be careful when using it for lacerations to avoid allowing the material to contact the open wound. It should stay of the skin only. Second, you are correct that a tourniquet can be left on a digit for 2 hours typically without consequence. However the studies documenting this tolerance are usually in exanguinated tissue in animal models or elective surgery and not acute trauma. But in actuality it's quite easy to control bleeding from a digital amputation stump. You simply wipe off any clot from the open wound and immediately apply a pressure over a thin qauze. Minimal pressure is required, remember the systolic pressure of a digital artery is only 25 to 30 mmHg and they spasm closed within 3-5 minutes. Tourniquet's are usually not really needed and if you place one you need to be responsible to remove it. That's the foolproof way to know it's been removed and you've always got to prepare for fools, they are around us! Thanks so much for your comment

[@linshore7451]

Thank you Doctor.

[@jessicawilkerson6294]

Hi Dr, I’m just curious to know if you listened to Ambers doctor (that didn’t treat Johnny) explanation of how he thought the injury occurred (obviously the way Amber described it), and if you thought that explanation could have been possible as well?

[@RealPlasticsDoc]

yes, but it's not a cogent explanation

[@jessicawilkerson6294]

@@RealPlasticsDoc I’m not a Doctor but I share your opinion. I say that based upon the way JD described the incident vs the way AH described her version of the incident, along with both Doctors medical conclusions. Thank you for taking the time to respond!

[@alexdogaru4066]

Please, more new videos!!!!!! Please!

[@TrymYoutubeMainChannel]

The bottle was thrown by Amber heard from maybe 5 meters away I think

[@chrism6904]

Please help!! .. If someone is having chest pain and they have Hyperacute T-waves in leads 2,3,aVF on a EKG, can you give them Nitro? .. I can't find this answer anywhere!!

[@CryptoMaisons]

morning dr, one question.. do you allow medical students to do rotations in your clinic?

[@RealPlasticsDoc]

Sometimes! Please email [e-mail] for employment opportunities

[@fardosaaden7784]

Where it's located

[@dac8939]

Are you rich?

[@cheypam]

Next time follow this pattern.. HE talks, then you mute him, and THEN YOU talk. Repeat. Please don't talk over recordings or live videos of people. Thank you.

[@RealPlasticsDoc]

got it, you're right thank you