Iquitos, Peru Visiting Educator Workshop

A Gratifying Conclusion To A Successful Trip

Tim Sproule and the Amazon River
Originally uploaded by interplast.

I finished the day with an exclusive trip to the top of an abandoned hotel in the center of Iquitos. It was abandoned many years ago because apparently it couldn’t be supported by the soft ground here.

I really enjoyed my time here in Iquitos. Teaching about burn reconstruction and skin grafting is very rewarding for me. By empowering local physicians here, hopefully I have contributed to the healthcare of more people than I ever could have reached on my own.

Tim Sproule and Local Doctors Operating on a Burn Patient

Tim Working With Local Doctors
Originally uploaded by interplast.

Thursday I gave another lecture on acute management of burns and then did a couple more cases: a burn scar contracture release in a 10 yr old girl, and a burn scar excision and flap reconstruction on a 6 or 7 year old boy. Both procedures went well, and following these I did another lecture, this time on electrical burns. It was amusing to discuss this particular patient of mine who suffered from hypothermia from being left out in a Canadian winter overnight at -20ºC - hard to imagine here with the temperature at 40ºC and 100% humidity!

Medicinal Plants in the Amazon

Amazonian Herbs As Potential Drugs?
Originally uploaded by interplast.

In the afternoon, Ernesto and I had a long talk about medicinal plants and the untapped potential of the Amazon to produce new drugs and creams, including those potentially useful for burn patients.

He and I drove around a little, and he showed me some of the more unusual species in the area. I suggested that perhaps a study could be done looking at the use of some of these natural remedies and how they compare to more conventional treatment. Maybe in the future we (or someone else) will do such a study...

Pain-Free Burn Patient

Pain-Free Burn Patient
Originally uploaded by interplast.

Following this we did rounds and interviewed the 8 year old girl who we had operated on the previous day. Despite her large wounds and extensive surgery, she was pain free and comfortable - very gratifying.

Demonstrating Skin Grafting On A Wild Boar

Demonstrating Skin Grafting On A Wild Boar
Originally uploaded by interplast.

Wednesday morning we ran the skin grafting workshop using an appropriate animal model for the region, a wild boar. Before doing the workshop I gave an in depth talk on how to use the various tools without injury. I was able to give all the hospital doctors and nurses that were interested experience in how to take grafts without the risks inherent in operating on real patients. This exercise was very well received. As is often the case, the nurses were more technically proficient than the doctors!

Skin Graft Lecture

Skin Graft Lecture
Originally uploaded by interplast.

Tuesday, I traveled back to the hospital in Ernesto’s 1960 vintage Wileys jeep and gave another lecture on “how to take a skin graft.” I followed this up by going to the operating room and helping Dr. Sanchez, a pediatric surgeon, perform skin grafts on an 8 year old girl. We were able to cover virtually all of her open areas: about 20% of her total body - using the tumescent technique that I had described in the morning. Following this were further meetings and discussions about the functioning of their burn unit, which the hospital people have asked me to help them with.

We had some useful discussions. One of the biggest problems is the lack of financial resources for treatment. The group is very interested in my ideas about low cost alternative burn care.

Burn Care Lecture at Loreto Regional Hospital

Loreto Regional Hospital
Originally uploaded by interplast.

Monday morning, at the request of Ernesto Salazar, one of Interplast’s medical partners, I gave an overview lecture on burn care to a group of doctors and nurses at Loreto regional hospital in Iquitos. I had traveled there from Lima the previous evening, after spending part of the afternoon with Ernesto’s son Alberto and his girlfriend Angie. Alberto is a recently-graduated doctor in Lima and came back to Iquitos Sunday night to serve as my translator for the talks.

Parc D'Amour

Parc D'Amour
Originally uploaded by interplast.

Hi. I'm Tim Sproule, a plastic surgeon from Toronto who is in Iquitos, Peru to spend a week teaching local doctors and nurses about burn reconstruction and skin grafts.

I arrived very late Saturday night from Toronto via Miami. It was -20ºC when I left Toronto, and about 35ºC in Lima when I arrived! The hotel I had picked was in Miraflores, a district of Lima, and Sunday morning I got up and went for a walk in beautiful sunshine. The first place I encountered was the parc d’amour- the lover’s park, which apparently is the local lover’s lane equivalent. It is commemorated with this huge statue of lovers overlooking a beautiful Pacific Ocean beach. Then I walked over to a pyramid structure from the Incas or some earlier culture which is right in the center of town - an amazing contrast. This country promises to have a lot of rich contrasts like this…