Stuff You Should Know - SYSK Selects: Your limb is torn off - now what?

Episode Date: February 29, 2020

Were you to be the unfortunate victim of a limb removal of any sort, you could take hope. Here in the 21st century, doctors have gotten pretty handy at reattaching arms and legs, replacing thumbs with toes, rebuilding breasts, all to great success thanks to microsurgery techniques. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

On the podcast, Hey Dude, the 90s called, David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s.

We lived it, and now we're calling on all of our friends to come back and relive it. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass

and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. And a different hot, sexy teen crush boy bander each week to guide you through life. Tell everybody, ya everybody, about my new podcast and make sure to listen so we'll never, ever have to say. Bye, bye, bye.

Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts. Hi there, everyone. It's me, Josh, and for this week's SYSK Selects, I've chosen So Your Limb is Torn Off Now What. It's a great classic episode filled with neat stories about things like exposed innards

and sewing muscles together. It's a good one, and it has a really great intro, if I do say so myself. It's from January, 2014, so enjoy. Welcome to Step You Should Know, a production of iHeart Radio's How Stuff Works. Hey, and welcome to the podcast. I'm Josh Clark, and there's Charles W. Chuck Bryant,

and this is Step You Should Know because Jerry's over there, too. How you doing, buddy? Besides, sick. I'm not sick. I've got a little bit of a bug, but that's it. You never admit when you're sick, I love it. Well, no, I'm...

Because you think that's the first step in being sick is saying, I'm sick. I definitely believe in psychosomatic effects. You know, the mind has an impact on the body. Well, if you can be a hypochondriac, surely you can do the opposite, right? Yeah. Yeah, you can will yourself in and not be sick.

Anyway, people, the show must go on, and I just want to point out how dedicated my partner here is to his craft. Well, I also want to say, I want to promise that it's not going to be like the great six-week illness of... No, you don't get sick. That was back in the old days, the unhealthy days. I smoked and everything.

Yeah, your body didn't know how to heal. So it was enjoying nicotine. Now, I'm just like, I'm not getting sick. I said it to myself last night, and here I am. Better than ever. Josh, 2.0. Thank you. All right, let's do this.

Okay, you ready? Yeah. I've got a story for you. I bet I know it. I'll bet you do, too. Eddie Knowles? Yeah. Yeah, you saw it.

His name is Everett Knowles, Jr., but everybody called him Eddie. Two days in a while. I find that unwholesome. Yeah, and I didn't know Eddie could be short for Everett. Never heard that. I don't think it is. I think he just didn't like his name.

Oh, okay. Because it seems like you should call him Every. Yeah, or Evie. Evie. Evie. Yeah. Ev. Ev.

The Big E. Something. The Big E. He was a little E, though. He was a little guy. Tiny E. Like a little Elvis. That's right.

Well, Eddie, we'll call him Eddie, because that's what he preferred to be called. Sure. He was walking home from school one day in Somerville, Massachusetts, which is a suburb of Boston, and he was walking along the railroad tracks, and there just happened to be a train loaded with gravel,

hauling out of the area very slowly, while he was walking alongside, and he said, you know what, I'm just gonna have a little thrill right now and grab onto this train. And he did. He successfully grabbed onto the train, was hanging with, I believe, his right arm. Yeah.

And was having the time of his life just dangling there when he misjudged the distance between the train, side of the train, and the side of a tunnel. Yeah. And he was pulled into the tunnel support, smacked it, and hung on for a second before he was dropped off of the train. The train kept going through the tunnel,

leaving Eddie kind of crumpled in a little shivering mass. Of pain. At the mouth of the tunnel. Yeah. So he stands up and he grabs his arm, he's like, oh, my arm doesn't feel very good. And he starts walking toward town,

and apparently he walked about 100 yards uphill when some workers saw him and said, grab that kid, because he was covered in blood, he was staggering, he looked like he was out of it, he's clearly in shock. So he grabbed it, ran and got a woman, because at the time, this is 1962, a woman was the only one who could provide any kind of initial emergency care.

Yeah. And a clerk at, I believe some sort of warehouse came out and started to apply pressure to this boy's wounds. But she had a little bit of trouble when she tried to close the wound with a tourniquet, she found that his arm wasn't attached to his body any longer. And he was just kind of holding it there.

Very luckily he was wearing a jacket, or else his arm would have been back at the mouth of the tunnel. Yeah, man, can you imagine like the guy's holding his arm basically to keep it from falling out of his jacket, although he didn't know that, you know? No, he didn't, he was in shock. Luckily he was still lucid enough

to like tell everybody who he was, where he lived, and they called the hospital, and the hospital scrambled some surgeons, but it wasn't until Chuck, he got to the hospital and they started cutting his jacket off that they realized the extent of the damage. This kid's arm was torn clean off. Yeah.

But the operative word is clean. Yeah, that's right. Because Eddie, Everett Knowles Jr. of Somerville Mass on what, May 23rd, 1962, became the first recipient of a full successful limery attachment surgery. First human recipient. Right, yeah.

That's a good point. They had done that before in dogs successfully, and they had done all the different surgeries that are required to reattach a limb, but they had never done all of them at once. Like they'd reattach nerves, they'd reattach bone, they'd reattach blood vessels, but they had never had a full amputation

in a human being successfully reattached. And from what I read, the doctor was, I don't know about excited, but they had been looking for a case because they thought like, I think we can do this, we just need the right case. Right, exactly. And he called his buddy and he was like, I think we got one, get in there.

They got the, like you said, they'd successfully reattached arteries, nerves, bone, that kind of thing, but never the whole shebang. So they said, well, we know how to do this. If somebody will just come along and present us with an arm pulled cleanly off, especially a 12 year old, because that definitely worked at his advantage.

Apparently an artery, when severed, will plug itself up, especially in younger kids, that plugging is way more successful and happens more quickly. So this kid just basically presented like the perfect case. The main artery, I guess is brachial artery, leading out of his shoulder was a full like two inches out of the wound.

So like they had a lot to work with and work they did. Yeah, and the arm was on ice and they began working immediately. This is Mass General, by the way. And they started with the arteries and veins. And then the nurse felt, well, they all sort of saw color and they described it as a glow,

kind of came back into the arm. This kid hopped the train, had his arm pulled off and within two and a half hours, they had gotten circulation back. Yeah, and the nurse grabbed the hand and said, hey, it's warm, that's good. It's pink and warm. She shook it, made it do the metal sign.

Everybody in the operating theater was laughing. The bone and the muscle and the nerve and the skin happened in later surgeries. And I think the nerve, they made a pretty important decision at the time was to wait on that all together and let it heal some more first, which is as it turns out,

actually as it turns out, most of this was sort of how they do it today. Like they perfected the process from that point through the 70s and in the 80s is when they really started coming with limb reattachment. The only difference that I saw was, and we'll get into it a little more, but they reattached the arteries first to get circulation,

I guess, to keep from more and more tissue dying. Right. And then they reattached the bone by driving a screw and using a hammer, they nailed the screw into the marrow and then reattached the arm bone, what is that, femur? No, femur's in the leg.

Yeah, femur's in the leg. I think I would have looked this up already. Yeah. The upper arm bone, then they drove that into the other end of the screw. Yeah, that's just... Normally now though, they do, they reattach the bone first to provide stability.

Yeah. So when you reattach the arteries and veins and stuff, they won't pull away. Yeah, and it was a success story because he ended up, he couldn't use that hand as his dominant hand any longer. Which is sad because he was a good pitcher. Yeah, but he was able to eventually get enough use out of it

to where they said about, like a left-hander would have use of his right hand. So he just sort of had to switch that up. But for 1962, that's pretty successful, especially considering in 1960 was the very first microsurgery performed just two years previously at the University of Vermont. Oh yeah.

Go catamounts. Nice. But... That was dedication. So microsurgery, that's really what we're talking about here. It's the use of a microscope to perform surgery. And when you're attaching, you're essentially sewing together little nerves

and blood vessels like a millimeter in diameter. You need a microscope and a tiny, tiny little needle. Right, and you're using tiny, tiny little suture thread, which is about as big as a hair. That's the stuff you're using to suture these blood vessels back together. Not cat gut. No, and it's an extremely involved surgery,

as you can imagine, but it's step by step. It's like first you do the blood vessels, then you do the arteries, and you do muscles, ligaments, tendons, all this stuff. And you're doing it in this process. But each part of the procedure is like an enormous surgery in and of itself. So like a limery attachment, which is called replantation.

Oh, I thought it was gonna be called like limery or something. Some people call it that. I'm a limerist. The saucier doctors call it limery. But it usually is like on a whole, the replantation surgery can last like an entire day. Yeah, it's intensive. And I read too that the whole microsurgery,

the concept of using a microscope for surgery was not accepted at first. Doctors and surgeons were like, no, we can't do that. We have to look with our eyes. And so it had to be perfected sort of on the fringe by surgeons who were willing to accept this might be the future.

And experiment in their basements. I guess so. On hapless victims. Maybe, or dogs. Yeah, I didn't get the, and I didn't look it up, but I didn't get the impression from this article one way or the other, how dogs lost their limbs to begin with.

Like, was it accidental? And they're like, okay, well, this will reattach it. Or were they cutting dogs limbs off and then reattaching them? Because I'm guessing it was probably the latter. You think? Probably. Yeah, I mean, we've talked plenty about that kind of topic.

Because I mean, think about it. Why would dogs limbs be pulled off in any more frequency than humans limbs and hence present more cases to practice on? I think they were cutting off dogs limbs and then reattaching, which is messed up. Yeah, it is. So you were talking about microsurgery.

What I saw was replacing toes for thumbs. Got big in the 60s, that was a big one. So you had a thumb on your foot or a big toe on your hand? Big toe on your hand. Wow. Because apparently 50 to 70% of all the utility in your hand is in your thumb.

And if you're missing a thumb, you might as well just not have your hand. You don't need a big toe quite as much. You can use a cane or something like that, thanks to your new toe thumb. And that became perfected in the 60s. Toe thumb, that's a good band name. Yeah.

And then in the 70s, free flat tissue transfer became a big thing, which is basically going to a part of your body, harvesting an area of your body like under your thigh, your abdomen. I think your back, lower back. And then just basically taking the gap and sewing it back together. So you have a scar, but you also have a portion of your body

that's diminished in size. And then taking that and using it to basically do what we understand as a skin graft, which requires microsurgery as well. It's just basically taking this part here and putting it back over here where there's a bunch of damage and reattaching all of the nerves and the blood vessels and everything.

Yeah, I saw when I was looking up photos of this kind of thing, I came across something that I'd never seen before. And I didn't get the story, but you could almost, I mean, I sort of gathered what was going on just from the photo series. But someone was degloved on their fingers, basically, from the hand knuckles forward, all the fingers had no skin. And from the looks of it, they inserted it into an arm,

like into a bicep, the fingers. And they lived there for a while, like inserted under the skin of the arm. And that skin, they later would remove the fingers. And it came off as like a big, flat skin graft, like sticking your hand in an envelope. Crazy. And eventually formed like webbed fingers and then fingers.

That is crazy. But like, I don't know. Is that new? I don't know, man. I just saw these photos. I mean, it doesn't really have anything to do with this. But it was just remarkable to see someone with their fingers stuck in their bicep under the skin.

Like, I'm having trouble visualizing this. I need to see these photos. Yeah, I'll take a moment to show it to you. Yeah, if you want to see some really gross stuff, you can just Google microsurgery or replantation as another one. Yeah, man. It's just nasty stuff out there.

But amazing, like that they can. And I looked at so many of them, I kind of got to that point. Or I was like, well, this isn't gross. What the body looks like without skin sometimes. Which is gross. No, it wouldn't gross out. Bodies without skin are gross. I don't think so.

I think it's the beauty inside. You can desensitize, my friend. I have. Well, before we get any further, Chuck, let's do a message break because I got some good stuff coming up. OK. Stuff you should know. On the podcast, Paydude the 90s called David Lasher

and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're going to use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it, and now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews, co-stars,

friends, and nonstop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting Frosted Tips? Was that a cereal? No, it was hair. Do you remember AOL Instant Messenger and the dial-up sound like poltergeist?

So leave a code on your best friend's beeper because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. SOS, because I'll be there for you.

Oh, man. And so will my husband, Michael. Um, hey, that's me. Yeah, we know that, Michael. And a different hot, sexy teen crush boy bander each week to guide you through life, step by step. Not another one. Kids, relationships, life in general can get messy.

You may be thinking, this is the story of my life. Just stop now. If so, tell everybody, everybody, about my new podcast and make sure to listen so we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts. So Chuck, we understand microsurgery now.

It's Frankensteinian, right? Yeah, basically just sewing stuff together. Yeah, because, I mean, let's say you have a dead person who has a great hand and you have a live person who's got a poor hand, you cut off the live person's hand, cut off the dead person's hand, and attach the live, or the dead person's hand to the live person. That's Frankensteinian, and that's what they're doing,

and it's pretty cool. It is pretty cool. But if this ever happens to you, if, say, you have a poor hand in that it's no longer attached to your wrist. Yeah, that hand sucks. Right. And it's all crushed and damaged or whatever. No, no, no.

Let's say it's intact. OK. And you say, you know what, I think, through my shock, that I might be a good candidate for replantation of my hand. What do you do? Well, you want to call 911 immediately, because that's just the first thing you do.

You go ahead and get folks on the way. Or you can ask someone with you to call 911 that's not putting anyone out. Yeah, that's true. If you can't dial, maybe you don't have hands. You could tell Siri to call 911. Yeah, that's your job. Yeah, I actually changed my Siri to a dude,

so it's not a hurt anymore. Oh, yeah. To an Englishman, actually. Really? Yeah, it's kind of fun. Reginald? I don't know what his name is, actually. But he'll say stuff like, I'll say call Josh,

and he'll say ringing Josh. Oh, yeah? Instead of calling, yeah. It's classy. Kind of fun. Anyway, you want to dial 911, get them on the way, and then immediately you want to just try and stabilize the patient.

You want to stop the bleeding either with heavy pressure or a tourniquet above the wound. Like a 1960s female. Yeah, exactly. And once you get the patient stabilized and they're not going to bleed out there in the kitchen or wherever it is, you want to get the digit or the hand or the limb and put it on ice, but not directly on ice.

Put it in a bag and then put that bag on ice. Yeah, you want to pack it in ice. As much ice as you can find. But you want to make sure that in the bag that you put the hand or the digit or whatever in, there's no ice and there's no water because water causes it to shrivel. And that means you won't be able to reattach it. Yeah, and ice you can actually, if I cut off my finger

and I threw it in a bucket of ice, it could actually get frostbite. Yeah, that's crazy. That is crazy. But it's also pretty cool. Yeah, and you don't want frostbite on your, because you won't be able to use it anymore. No, frostbite is just dead tissue

brought about by exposure to extreme cold. That's right. So after. That's a t-shirt right there. After you've got it on the ice, in the bag on the ice, you've called 911, you've got the bleeding stopped, you want to cross whatever fingers you have remaining and hope that you've got a good hospital nearby

with some surgeons that aren't doing much at the moment. Right, or who are willing to cancel their schedules and say, let's go do this. Yeah, get off the golf course. So when you get to the hospital, there's some things you can expect. If all of your surgeons have come in from the golf course, they should be ready and waiting for you.

And like we said, first they're going to reattach the bone to provide stability for the rest of the surgery. And there's probably still going to be a little bit of a gap there, because they need to get in there. And then they start reattaching your blood vessels. That's right. And just like with Eddie Knowles, that just gets the blood flow going and essentially makes

that limb alive once more. Right. Well, it also keeps it from further dying. Because Chuck, it turns out that there is a finite amount of time, which is understandable. But we are aware of how much time a limb can just sit around in the hot sun, starting to go fetid. And so for example, if you have a whole arm or a whole leg

cut off, remember death proof? Yeah. That girl has her legs sticking out of the window. And Mad Mike, is that his name? Kurt Russell, I remember. When he hits him and her leg just goes, yeah. If she had survived, and her leg just laid there out at room temperature,

it could have been good for six to 12 hours. I imagine you're really pushing it at 12 hours. Yeah. But if, say, you have somebody who's like, this leg needs to be put on ice and does everything right, it could stay refrigerated for four days and still be reattached. Yeah.

They point out, though, in this article, ideally, you're having that surgery that day. Yeah. But if you. Within hours. Yeah. Within minutes, if you're talking ideally. Basically, the sooner the better.

As soon as they're ready to go, you should be ready to go as well. Yeah. But you're right. If that is not the case and you have some good refrigeration going on, you can last for about four days. Yeah. And apparently, it's not even necessarily the skin tissue that leads to problems and reattachment after being exposed

to room temperature. It's muscle degradation. Oh, yeah. Yeah. Interesting. So you get there, you're getting your surgery done. You probably are going to expect to go through that first long surgery, bone reattachment, blood vessel, maybe some muscle

fiber. And then. Intend an action, maybe. Sure. And then they'll say, we'll put the nerves off for later. And then later on down the road will be a skin graft of some kind, like a free flap surgery like I was talking about. And the free refers to the free, like this part of this tissue

from your body has been removed, the donor site. Oh, it's not the cost of the surgery? No. OK. It's been cut free. Right. And there you have it. That makes sense.

And then it really is simpler than you think. It's reattaching. And hopefully everything takes. And you fight the infection off. And you start the rehab process, which takes a long time. And it's grueling and not fun. It can be weird at first. They point out an article and be weird to look down

and see your arm reattach. But I imagine no weirder than looking down and seeing your arm not attached. You know? It'd probably be a comfort to see it reattach. You're a jerk if you're like, oh, it's kind of crooked. Yeah. But apparently sometimes it can feel a little different.

And that can be a little strange and off-putting. Sure. It's not like, oh, I'm just like I was before. Right. Better than ever. Right. And Tom wrote this one, my good friend Tom Sheeve. He said he also talked about something called cross transfer.

This was mind blowing. Which is basically like if just replantation is Frankensteinian, this is even more. So. Yeah, I didn't quite get the purpose of the hand. Basically you're getting a left hand on your right arm, let's say. So your thumb and your pinky would be in weird places.

Right. Your palm's still facing the right direction. But your thumb is switched. Yeah, but what's the point of that if you have a bad hand and a good hand? I don't know if they only had a left hand available at the time. I don't know that one. I got the other one where basically they take your lower leg

beneath your knee. So like if your upper leg is damaged and your lower leg is fine. Let's just say your upper leg is wasted for whatever reason. But your lower leg is fine. They'll cut it off the lower leg and basically turn it around. Right. And then your knee becomes locked. Your calf muscles then serve the function

that your thigh muscles used to. Right. And your knee joint is now in your ankle. Then you also are going to be wearing a prosthetic obviously because you have no thigh muscles. And your turned around foot, which is now backwards, is extra support for that prosthetic foot, your leg, your limb.

Wow. It's pretty cool. It's basically saying like, how can we take this and use it to even better utility now that its original purpose has been destroyed? Yeah. It's pretty cool. Yeah, I tried to find photos of a cross-transferred hand,

but I couldn't find any photos. And weirdly, pictures of Madonna kept popping up. Does she have something? I don't know, dude. Like I tried all sorts of Google searches and she images of her kept popping up. So I don't know. Maybe she's got two left feet or something.

She does not. What was that in Waiting for Guffman? He literally had two left feet. It was kind of a dumb joke. I thought it was a Best in Show. So Josh, that's one way. We talked about microsurgery. But there is perhaps another, even better way,

which we'll cover right after this message break. Stuff you should know. On the podcast, Hey Dude, the 90s called David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're going to use Hey Dude as our jumping off point, but we are going to unpack and dive back

into the decade of the 90s. We lived it, and now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews, co-stars, friends, and nonstop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting Frosted Tips?

Was that a cereal? No, it was hair. Do you remember AOL Instant Messenger and the dial-up sound like poltergeist? So leave a code on your best friend's beeper, because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling

of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. The hardest thing can be knowing who to turn to when

questions arise or times get tough, or you're at the end of the road. Ah, OK, I see what you're doing. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place, because I'm here to help. This, I promise you.

Oh, god. Seriously, I swear. And you won't have to send an SOS, because I'll be there for you. Oh, man. And so will my husband, Michael. Um, hey, that's me. Yep, we know that, Michael.

And a different hot, sexy teen crush boy bander each week to guide you through life step by step. Oh, not another one. Kids, relationships, life in general can get messy. You may be thinking, this is the story of my life. Just stop now. If so, tell everybody, yeah, everybody about my new podcast and make sure to listen so we'll never, ever have to say bye,

bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple podcast, or wherever you listen to podcasts. All right, so we've discussed how you can have surgery, but there may be an actual way to regrow things. Yeah, this is far, by far, the more preferable of the two. Yeah, like fingers, but not like, you know, you can't lose a whole finger and regrow it.

It's got to be above the bone. Like, let's say you get the tip of your finger, like your fingernail cut off. Right. And you can't find it. And even better, this just involves like dumping a magic powder on that, that wound. So if you have your finger cut off below the nail,

right below the nail, which happened to a guy in Cincinnati in 2005 who owned a hobby shop, I used to love those places. Oh, me too. Man, I'd go in and be like, I just want all the model airplanes and everything. Yeah, Eddie's Trick Shop in Atlanta was my go-to. Oh, nice. Which I've just discovered still exists,

not too far from my house. Is it a magic shop? It's like everything, like they had models, they had magic kits, they had whoopee cushions, and sort of like a catch-all. Yeah, I'd liked both of those, but I never went to one that was the same. Yeah, yeah.

Anyway, this guy, this hobby shop owner, as far as we know, he sold no magic items. He was demonstrating why a motor was very dangerous in an RC plane. He did a good job, I guess. And cut his finger off. And apparently, his brother had something to do with tissue regeneration and said,

Yeah, he was in the biz. Yeah, the guy went to the doctor, the hospital, and the doctor was like, we'll give you a skin graft to just kind of cover this weirdness, but you lost your finger T.S. Yeah. And the guy's brother was like, don't give the skin graft just yet.

Come over, I'll give you a beer. And I'm going to put something that's called extracellular matrix on your wound. And let's see what happens. And he did. Yeah. And magic happened. And it re-grew.

The guy not only re-grew his finger, he re-grew, apparently not the bone, but very surprisingly, the nail bed and fingernail, which apparently, you don't grow a nail bed back. Even if you cut off just the tip of your finger, that nail bed's never growing back. This guy's nail bed grew back. That's awesome.

Extracellular matrix is awesome. That's basically the glue that holds our cells together. And not just us, plants and animals and trees, and they all have it. And it functions outside the body cells. That's why it's called extracellular, obviously. And it's collagen. We've talked a lot about collagen, the protein that's

super good for all kinds of things. Especially growing skin. Yeah, like it's in skin cream and stuff like that. Sure. So typically, what they use is, this was a powder from Pig Bladder. But I've seen, I saw a video on the New York time site that showed how they do it today.

And this is mainly for, let's say you didn't want a skin graft for some reason, or it wasn't possible to get a skin graft. And you've lost all the skin on your thigh. They would get a Pig Bladder, and they spread it out, and they remove all the cells, basically. Yeah, because this stuff doesn't have pig cells. No, it doesn't have pig cells.

This is harvested from a pig body. Yeah. But they still remove the cells and all the DNA with a chemical bath. And basically, what's remaining is the matrix in it. They end up drying it out, and it looks like, and cut it into sheets, and it looks like a sheet of parchment paper.

And then they will put that on your leg, and it immediately just starts going to work. Yeah, they used to think that extracellular matrix was just something that provided structure for cells to grow around. Yeah, like a fetal in the fetus. Yeah, because if you're in the fetus, and something happens, you lose a toe. In the fetus.

If you are a fetus. If you're in the fetal position in the womb, and you lose a toe, that toe's growing back. You grow a vestigial tail that goes away. Your feet and hands start out being webbed, so you're growing a lot of stuff and then getting rid of it. But you can also regrow stuff that you're not supposed to lose.

Yeah, up to the age of about two. And then I think the general idea is that the extracellular matrix just kind of goes dormant in humans. Right. But they thought that it was just structure. And then they realized that, no, this is actually creating some sort of signal to the rest of the body

to say, hey, don't scar. Regrow instead. And it goes and recruits stem cells and says, come over here, and let's rebuild this finger. This hobby shop accident was too ironic. Let's reward this man with a regrown finger. And don't forget the nail bed. That's what extracellular matrix says to everything else.

Yeah, and it's pretty cool. The problem with why you can't normally just regrow a finger is because when something like that happens, a trauma happens, your body recognizes it and the immune system kicks in. And it's going to swell up and get inflamed. And scar tissue is going to start to form. And the extracellular matrix prevents the inflammation,

prevents scar tissue from forming, and basically tells the body, no, I'm just going to grow, like normally, not scar tissue, just regular old cells. But like you said, after a certain age, it just goes away. Like we have the extracellular matrix still, but its ability to trigger regrowth just becomes dormant or something happens to it. And with this pig bladder stuff, they're starting to wonder,

is there a way that we can just trigger this naturally in the body? And if that's the case, then say hello to regrowing a whole head. I mean, you never know, because they point it out that like deer can regrow antlers and things like that. And they're not so different than us cellularly. Right, because it has bone cartilage, skin.

All those things are in your hand, your arm, your leg. And you would need to regrow all those. For something to really be considered regrown, you can't just regrow the leg, but not the bone. It'd still be impressive, but your leg is kind of flopping there. Have you ever seen the picture of that UFC fighter who's like kicking the guy, and he breaks his own leg,

and it's just like almost like a cartoon? Yeah. Or a McGayhee? Oh, yeah, well, it's McGayhee. Yeah, that stuff triggers the old mirror neurons big time. It makes me weak. So that's basically it. I mean, they've been experimenting with war veterans,

Iraqi war veterans. And actually, the New York Times video I saw, it was a war veteran who was having this done to his thigh. Yeah, his tendons, right? I think it was skin and tendons, and yeah. And it was, you know, it looked kind of gnarly, but it was functioning. Yeah.

And that counts. You got anything else? No, I think that's it. There's literally nothing else to say about this. I agree, sir. All right. Well, then if you want to learn more about replantation, you can type that word into the search bar

at HowStuffWorks.com, and it'll bring up a couple cool things. At the very least also, type in extracellular matrix, which is pretty cool sounding. And that'll bring up another article, too. And since I said those things, it's time for Listener Mail. That's right. I'm going to call this correction. Get these from time to time.

We like to read them, yeah, from time to time. Hey, guys, and Jerry, love the work you do. I love listening to the show. I wanted to write in, though, with a correction regarding Lewis and Clark. I'm working towards my PhD in art history, and I am particularly interested in the history of medicine and disease.

In the middle of the show, Josh mentioned that the Adventure Party inadvertently discovered syphilis that had not been known to Europeans up until that point. This is actually not quite the case. Syphilis goes back pretty far in European history. It was first documented in the late 15th century after a conflict between France and Italy

and remained an issue for Europe, peaking around the mid-19th century. 19th century. Did I say that right? Yeah, you said it. OK. Josh did have part of it right, though, when he said that the party blamed it

on Native American groups. Early on, everyone wanted to blame the disease on everyone else, no surprises here. But after that initial conflict, the French referred to syphilis as the Neapolitan sickness, while the Italians named it the French sickness, a trend that continued as the stuff spread. You, no you.

If you're interested, it's really fascinating stuff, especially the cures that became popular. Mercury was a really nasty one. History of syphilis by Claude Cattel is a pretty good reference. He read a book called the History of Syphilis. Somebody wrote a book called the History of Syphilis. Anyway, just wanted to, and that was Claude Q-U-E,

accent of goo, T-E-L, so he's French. That was nice. Isn't that what that's called? I don't remember anymore. I don't either. Anyway, just wanted to point that out. Garçon. Yeah.

That is from Kathleen Pierce. Nice. Well, thanks a lot. She's into disease. Thanks for your paintings about disease. I guess so. Thanks a lot for letting us know that, Kathleen. I feel like I've been set straight.

If you want to set us straight, we'd like to be corrected, right? Yeah, and nothing better. All you have to do is tweet to us to initiate contact. You can tweet to us using our handle, SYSK Podcast. You can go on to Facebook. That's another great way to contact us. Yeah, you can complain there.

We people love doing that. We're at facebook.com slash stuff you should know. You can send us an email to stuffpodcast.howstuffworks.com. And although you can't complain, you can enjoy our website, stuffyoushouldknow.com. Stuff You Should Know is a production of iHeartRadio's How Stuff Works. For more podcasts from iHeartRadio,

visit the iHeartRadio app. Apple podcasts are wherever you listen to your favorite shows. On the podcast, Hey Dude, the 90s, called David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're going to use Hey Dude as our jumping off point,

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