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
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