venerdì 15 maggio 2015

Orthopedic marathon

Chaaria is nowadays overwhelmed by so many patients coming to us with different orthopedic ailments. Adding the number of orthopedic patients to the normal very high turn-over of our hospital makes the working conditions really demanding and extremely heavy.
Every day we start theater early in the morning and we finish very late, but in spite of that, our pending operations are always very many…we are not able to cope, and the more we operate, the more the wards are full of patients still waiting for theater.
A big limitation to our ability to respond to the number of people to be operated is the fact that our staff is somehow limited: we actually operate in 2 theaters, but for 4 days a week we have only 1 anesthetist available.
The other problem is the sterilization of the instruments: after an operation of ORIF (open reduction and internal fixation) we must wash and sterilize the instruments. 
We normally alternate an orthopedic operation with another one of general surgery or gynecology, in order to give our sterilization department possibility to cope. 
We must also consider that even the requests for general surgery are very many and we try always to balance our operation list, in order to give room to orthopedic and non-orthopedic surgical cases.

The other problem is the outpatients requesting a very big effort from the orthopedic surgeon to jump from theater to the consultation room from morning to evening. Outpatients are very many and they need quite a lot of time, making the people to be operated wait up to when the surgeon is free again from his long list of consultations.
But another fact we have seen this year is the ever increasing complexity of the cases we receive: fractures neglected for many months, associated with abnormal positions of the bones already ossified in wrong postures; mal-unions secondary to severe osteomyelitis, above all after exposed fractures. 
This means that the operations are difficult and extremely long.
The photo I share refers to one of today’s operations, on a man who had terrible fractures of femur and tibia.  
The bones were practically blown up after a motorbike accident 3 months before. The man did not have any attempt of surgical treatment, apart from traction. Unfortunately there was also an important osteomyelitis. 
Putting plates or intra-medullary nails has appeared unrealistic and dangerous because of the infection. We have therefore opted for external fixators (exofix), implanted under X-Ray guidance.
Even tomorrow and Sunday we will have a long operation list starting as from 6.30 am, in the hectic attempt of operating all the difficult orthopedic cases before Dr Luciano Cara goes back to Italy. 

Bro Beppe

Nessun commento:

Chaaria è un sogno da realizzare giorno per giorno.

Un luogo in cui vorrei che tutti i poveri e gli ammalati venissero accolti e curati.

Vorrei poter fare di più per questa gente, che non ha nulla e soffre per malattie facilmente curabili, se solo ci fossero i mezzi.

Vorrei smetterla di dire “vai altrove, perché non possiamo curarti”.

Anche perché andare altrove, qui, vuol dire aggiungere altra fatica, altro sudore, altro dolore, per uomini, donne e bambini che hanno già camminato per giorni interi.

E poi, andare dove?

Gli ospedali pubblici hanno poche medicine, quelli privati sono troppo costosi.

Ecco perché penso, ostinatamente, che il nostro ospedale sia un segno di speranza per questa gente. Non ci sarà tutto, ma facciamo il possibile. Anzi, l’impossibile.

Quello che mi muove, che ci muove, è la carità verso l’altro, verso tutti. Nessuno escluso.

Gesù ci ha detto di essere presenti nel più piccolo e nel più diseredato.

Questo è quello che facciamo, ogni giorno.

Fratel Beppe Gaido

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