Not Your Ordinary Plastic Surgery!

We have just finished almost two months of plastic surgery!
For those of you who are put off by the words "plastic surgery," do not be alarmed!  We are not performing tummy tucks or nose jobs.  Our plastic surgeon, Dr. Tertius Venter, helped many patients by performing a variety of surgeries.  With each patient, I will explain the types of surgery performed.

This is Ben Ali - he totally captured my heart!  He is a two-year-old boy who got burned over a year ago.  As the burn healed, the skin contracted.  Rigid scar tissue formed over the arm, elbow, and wrist.  His right arm contracted, and he was unable to straighten the arm due to the scar tissue.  In surgery, the scar tissue was removed and the arm straightened.  A layer of skin was removed from his thigh and placed over his arm over where the scar tissue previously laid.  The thigh, his donor site, and his arm, the graft site, are closely monitored to ensure that the wound is healing properly.  At a certain point in the healing stage, a physical therapist started working with Ben Ali to use and strengthen the muscle and tissue of his arm.

Once his wound was healing, Ben Ali was trying to use his arm more and more so physical therapy gave him a splint to keep his arm straight.  It was torture for a young boy!  He only took it off for his physical therapy (PT) exercises.

But he did not let the splint stop him from having fun!

The surgery to release a burn contracture has two purposes:
First, to restore function to a limb.  Ben Ali will have so many more options with two fully functioning arms.  One day, he'll be able to provide for his family.
Second, to restore normalcy to a person's look.  Dr. Gary Parker said it best - we believe that a person has the right to look human.

Meet Melina.  She had an extra digit on each toe, protruding at a 90-degree angle from her foot just below the big toe.  The only shoes she could wear were flip flops!  She was not able to hide her deformity.  This simple operation took away the extra toes along with any sense of shame she felt.  You can see the suture line on her right foot.

This little man is Finoana.  He is a five-year-old boy who was born with syndactyly.  This means two or more of his digits were fused or webbed.  In his case, the fourth and fifth digits (ring and pinkie fingers) on both hands were not separated.  In the OR, a small skin graft taken from his groin, the crease where his leg and torso meet.  The skin was placed in between the newly separated fingers.

He had a very big personality for such a little boy!

Florence is a nine-year-old girl who had spilled boiling water on her foot many years ago.  As she grew, the scar tissue remained stiff and prevented the foot from developing properly.  As the unburned tissue grew normally on the sole and sides of her foot, the burned tissue on top of her foot remained rigid.  She was not able to walk normally.  Like many people do when faced with a handicap, Florence adapted to her less-than-normal foot.  She could walk.  However, she was not able to bend her ankle much and her toes were fused together.  As she would continue to grow, the foot would continue to deform.  Perhaps later on she would have a pronounced limp, perhaps not.  Like the first patient discussed, Ben Ali, Florence also had a skin graft taken from her thigh and placed over the top of her foot where the scar tissue was removed.  She has been here on the ship for almost two full months now!  Her wound is healing slower than most, but recent reports are very positive.  She can go home soon...

This is Landrino.  He first appeared in the "Back to Work!" blog from November 2014.  Here he is waiting in line during screening.

Landrino was burned along the left side of his body.  During the operation to release the burn contractions to his hand and foot, Dr. Tertius also removed the keloids on his ear.  A keloid is a growth of scar tissue formed after an injury.  Landrino, his mother, and his sister have captured the hearts of all the nurses.  Here is Zuela, his young sister:

The Rakotoniriana twins each had extra digits.  One on the left hand and one on the right hand.

Here is one of the girls as she reaches for a toy during PT.  You can see where the surgeon removed the extra digit near her fifth, or pinkie, finger.

Below is a collection of photos from some more of our patients, both pre and post op.

 

Because the wounds take a long time to heal, our patients become good friends.  We have a lot of fun with them, both on the wards and outside.  Every day, the patients get an hour of playtime outside.