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Burn Victim Yajaira Reaching For The Sky

   Yajaira's Functionality After Surgery 
  Originally uploaded by interplast.

Piura, Peru - Dr. Ian Wilson, Webster Fellow:  Eight-year-old Yajaira was severely burned last August when a kerosene cooking fuel canister exploded in the kitchen, engulfing it and her. The burn affected most of her body, and despite receiving therapy soon after the traumatic event, she developed disabling contractures of both her limbs. Dr. Roberto Roddi (an Italian plastic surgeon and fellow surgical team member) and I decided that we could release and reconstruct the armpits on both of her arms. We performed a one-hour burn contracture release with a Z plasty reconstruction. In English, that means that we allowed the melted skin that was previously stuck together to be separated.

  Yajaira's Functionality Before Surgery 
  Originally uploaded by interplast.

Whereas previously she could not lift her arms above her head, now she can. It’s remarkable that even in the early post-op period, you can see that she can now lift her arms above her shoulders. This will allow her to do the things that every young girl wants to do but many take for granted, such as raise her hand in class, play sports or even comb her hair.

Interplast provides burn contracture surgeries that truly help these children overcome functional limitations. Burn surgeries are so critical to a child’s development, but can sometimes get overshadowed by easier, more night-and-day procedures such as cleft lip repairs. But patients with burn contractures are often unable to perform daily activities, and after the surgery they notice a huge difference in their ability to live their life as they choose. In a profound way, we have truly helped heal Yajaira’s body and changed her life.

Cleft Lip Trombone Player

  Trombone Player 
  Originally uploaded by interplast.

Piura, Peru - Seth Mazow, Interplast staff:  The last day of a surgical trip the team is busy packing so we only do a few short cases that can be done under local anesthetic and therefore do not have as involved a recovery process. So we tend to do older patients who can make do without general anesthesia.

Pedro is 29 years old, and his cleft lip repair was one of the last procedures done by Interplast on this surgical trip to Piura, Peru. Everyone in his family is a musician, and he is in music school to learn how to better play the trombone, as his dream is to play in the Piura symphony orchestra. His favorite composers are Mozart, Beethoven and Vivaldi. He used to play the drums as a child because it was an instrument that did not require anything of his mouth. But he has always loved the trombone, and three years ago decided that he was not going to let his cleft lip get in his way. He is a promising student, but his skills have plateaued because the trombone mouthpiece was not designed for a mouth with a cleft lip. His teachers told him about Interplast, so he came here and got his lip repaired.

Pedro believes that he can inspire people through his music. He wants to touch people, and the trombone really speaks to him. Hopefully, he will be able to touch more lives now with his repaired cleft lip.

Hand Surgery

  Hand Surgery Before And After 
  Originally uploaded by interplast.

Piura, Peru - Seth Mazow, Interplast staff:  Luis is a four-year-old who was born with a severe hand deformity called syndactyly, which means that his fingers on both hands were fused together. Because his hands look like a mitten, his functionality has been extremely limited, and he has been unable to use his fingers. The Interplast surgeons separated his fingers, using flaps and skin grafts; even the bone had to be divided to recreate his digits. As a result, he will have better hand functionality, and will have more of a chance to have a more normal school life and employment prospects. Interplast will see him next year and do a similar operation on the other hand--doing as much for him as we can.

Hoping To Inspire Future Humanitarians

  Ian Wilson Giving His Speech 
  Originally uploaded by interplast.

Piura Peru - Dr. Ian Wilson, Webster Fellow:  Yesterday I talked to roughly 50 medical students at the local medical school. Dr. De La Cruz, the local Interplast surgical outreach director, organized the talk, and scheduled it around the students’ exams. I gave my “Have Scalpel, Will Travel” talk, which elaborates on my experience performing life-changing reconstructive surgery with minimal resources in challenging environments such as South Africa and Cote D’Ivorie. I have given many talks before, and have become accustomed to the “I have to be here so I’m going to pretend to be somewhat awake” look. But these students were actually genuinely interested in reconstructive surgery. Six students stayed late and asked a lot of questions, and were interested in coming by the operating room to see what Interplast is really like. I told them that because this surgical trip is almost over, they should coordinate their schedules so they can work with next year’s team to get a more full educational experience.

I talked a lot about Interplast and its surgical team model, but I am more excited about the long-term goal of empowering local doctors to provide reconstructive surgery in their native countries. Dr. De La Cruz repairs cleft lips all year long, and has been able to help more children in one year than could have been possible with numerous team trips. This model seems much more sustainable to me. Hopefully, I inspired some of these bright students here in Piura to consider plastic surgery as a career, and charitable work for the poor as a calling.

Dancing Baby After His Surgery

  Dancing Baby After His Surgery 
  Originally uploaded by interplast.

Piura, Peru - Seth Mazow, Interplast staff:  Jesus Alejandro has recovered nicely from his surgery. Although he wasn't in much of a dancing mood, he and his parents are still pretty happy with the results.

Dancing Baby

  Disco Jesus Alejandro 
  Originally uploaded by interplast.

Piura, Peru - Seth Mazow, Interplast staff:  This morning, a dancing baby walked into the hospital. Little Jesus Alejandro is five months old, and is cute as a button even with his unilateral cleft lip. He was very amenable to our doctors handling him, and we managed to find some time in the schedule to squeeze him in this afternoon to repair his cleft. By some stroke of photographic genius (or luck), Jesus Alejandro looks like he is rocking out disco style in this photo. He also has the “Dance Like An Egyptian” dance move in his repertoire, and he quickly became a team favorite.  I will post some post-op pictures later tonight when they are available.

Ethicon Sutures In Action

  Dr. Richard Siegel Using Ethicon Sutures 
  Originally uploaded by interplast.

Piura, Peru - Seth Mazow, Interplast staff:  Dr. Richard Siegal, a plastic surgeon from Honolulu, is one of our three plastic surgeons on this trip. He is a veteran of many Interplast surgical teams, and his outgoing nature and awesome surgical cap make him a hit with the patients. He is always talking and joking with them, trying to make them feel at ease. But when it comes time to get down to business, he gets real serious, real fast.

In this photo, he is performing a cleft lip revision on Paolo, a six-year-old girl. He is using one of the hundreds of sutures we take on each surgical trip, all donated by Ethicon, a division of Johnson & Johnson. Multiple sutures are used in every surgery, and they are an integral part of the surgical process.

The only female Vietnamese anesthesiologist currently in Peru (probably)

  Dr. Hien Nguyen Thi With A Patient 
  Originally uploaded by interplast.

Piura, Peru - Seth Mazow, Interplast staff:  Dr. Hien Nguyen Thi is a Vietnamese anesthesiologist. She helps coordinate all of our surgical trips to Vietnam, and is one of the best anesthesiologists in her country. It is fun to watch her work here in Peru. Her English is good but not perfect, and her Spanish is terrible. But she manages to find other ways to communicate with patients. Here she is calming a patient by showing her a music video from her handheld device.

One of the most important but often overlooked duties of an anesthesiologist on an Interplast trip is physically getting the patient from the waiting room to the surgical table. Sometimes patients go willingly, but others only go kicking and screaming. Literally. Hien is a somewhat diminutive 1.5 meters (almost five feet) tall, so she has to rely on her charms to coax the patients into the operating room. Luckily, Hien is charming, so she never has any problems.

She jokes that the kids think of her as a monster because she is the last one that they see before going to sleep, and the first one they see when they wake up groggy and unhappy. But c’mon, how could anyone think of Hien as a monster? She’s one of the sweetest people on this surgical trip.

Valleylab Cautery Unit Being Used By Ian Wilson

  Ian Wilson and Valleylab Cautery Unit 
  Originally uploaded by interplast.

Piura, Peru - Seth Mazow, Interplast staff:  Dr. Ian Wilson, shown here operating on the right of the nurse, is the 2006-2007 Webster Fellow. This unique fellowship allows one newly trained plastic surgeon to travel the world for a year going on Interplast surgical trips, meeting surgical outreach directors and embarking on mini-fellowships with renowned plastic surgeons. Because they go to so many of our sites within a short period of time, they become the “eyes and ears” of Interplast, evaluating facilities, sites and programs.

We are lucky to have Ian with us on this trip. He is Irish by birth, but studied in the US and has worked in Haiti, South Africa, Cote D’Ivoire, and numerous other challenging surgical environments. Today he will be giving a lecture to the local medical school about Interplast and plastic surgery. He is hoping to inspire some of them to pursue plastic surgery as a career, and to use their training in service for the poor.

Ian is using a cautery unit generously donated by Valleylab. The unit (the blue machine to the left of the nurse’s right elbow, attached to the cautery pen in Ian’s hand) is used in every surgery Interplast performs. These units cost thousands of dollars, and without them, cleft palate repairs would not be possible.

RMHC Making A Patient Happy

  RMHC Making A Patient Happy 
  Originally uploaded by interplast.

Piura, Peru - Seth Mazow, Interplast staff:  Interplast patients are not allowed to eat or drink for a few hours before surgery because doing so would compromise anesthetic safety. Sometimes, surgeries in the morning take longer than expected, pushing back the patients scheduled for the afternoon. This means that a patient who stopped eating or drinking at a given time will have a longer period of time with nothing in their stomach. Hunger can sometimes make children (and bloggers) cranky, so we try to give the kids something to do to occupy their mind, lest they start throwing a fit that spreads throughout the ward.

Luckily, Ronald McDonald House Charities (RMHC) provided us with coloring books and crayons to give the kids something to do while they await surgery and during their recovery. RMHC sponsors many Interplast surgical trips all around the world. Over the last seven years, RMHC has assisted more than 9,600 children to receive life-changing surgery. Interplast is very appreciative for its outstanding support.

This surgical trip was generously sponsored by a donor who wishes to remain anonymous, to whom Interplast and children like Jasmin are deeply grateful.

Global Health