Please mr.vivek bindra and all Indian people ,see the link above,it is a real case study-doctors and hospitals,and see what is true-mr . viveks bindra’s case study or this one
Harmanpreet kaur
xii-med,student
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Picture: Face two
As the machine pulled her head back, it took
just a few seconds for the skin of her face and scalp to tear off and come
apart in two pieces.
Written by Rakhi Jagga | Updated: June 21, 2015 11:56 am
Next month, the world’s first full-face
replant patient will become a mother. Rakhi Jaggameets Sandeep Kaur and her remarkable
doctor Abraham Thomas
Face Replant: A face replant is a procedure
that reconnects the blood vessels, nerves, bones, muscles and other supportive
structures to the skin of a person damaged in a mishap. Unlike a face
transplant, which relies on an external donor, a face replant uses the skin and
grafts from the person undergoing the procedure.
The procedure: The damaged skin is first stored
in ice and kept aside. The 8 cranial and 14 facial bones are shifted to
specific positions if they have been damaged. A surgical microscope then
connects the 17 major facial arteries and 7 primary veins to begin the blood circulation.
Finally, the 40 facial muscles are connected and the skin is sutured back on.
If the skin if severely damaged, grafts from the patient’s back, buttocks,
thighs, or chest are used. The structurally complex eyelids and mouth are the
toughest to replant and involve complications.
The risks: There is a risk of a clot blocking the
blood supply to the newly sewn face and killing the replanted tissues. A series
of recontructive surgeries are needed after the first operation, which takes
between 2 and 10 hours.
The next step: The world’s first partial face
transplant on a living human was carried out on November 27, 2005, in France.
Isabelle Dinoire underwent surgery to replace her original face, which had been
mauled by her dog. On March 20, 2010, a team of 30 Spanish doctors carried out
the world’s first full face transplant, on a man injured in a shooting
accident.
Sometime towards the end of July,
Sandeep Kaur will become a mother. Twenty-one years after what the NYU School
of Medicine calls “the world’s first full-face operation” came bleeding to
Ludhiana’s Christian Medical College and Hospital with her face in two pieces,
she will be wheeled into hospital for her first medical procedure that wouldn’t
involve her face.
Dr Abraham Thomas will not be
in the room, but he is unlikely to be far away. This is the story of a
girl, a doctor, and a 21-year-long association to give her her old face and a
new life.
It’s the scream that Sandeep
remembers most vividly. And it wasn’t even hers. It was a July afternoon
in their Chak Shekhupura Khurd village in Malerkotla, muggy and quiet. June
1994 had been very hot, and the temperature had just started falling. The only sound
around at that time of the day on July 23, Saturday, was that of the thresher
machine, kept in the open area of the house, next to which the nine-year-old
and her cousin sat, cutting grass.
Sandeep was proud of how well she
operated the manual handle starter that controlled the thresher’s speed. Around
3.30 pm, her attention slipped for a moment, there was the sudden pull of air
pressure and a tug, and her long pigtails got swept into the motor of the
thresher. As the machine pulled her head back, it took just a few seconds for
the skin of her face and scalp to tear off and come apart in two pieces.
“I stood up. I had no idea
what had happened. I was feeling no pain at all, my face totally numb,” Sandeep
remembers. “I walked towards my mother who had her back towards me. Tapping her
on the shoulder, I asked, ‘Mumma, meinu ki hoya hai (what’s happened to me)?’.
She turned, saw my bleeding face with no skin, and screamed aloud.”
Within minutes, almost the
entire village had gathered. Sandeep’s father Sudagar Singh, who worked in the
Irrigation Department then, was away at office, having been summoned for some
urgent work on his day off.
“Mumma was dazed, she didn’t
know what to do. A neighbour wrapped my face in
a sheet, while the village’s rural medical practitioner,
Harjinder Singh, rushed me to Malerkotla Civil Hospital, a 15-minute drive, in
his jeep,” Sandeep says.
One of the doctors there showed a fortuitous presence of mind. He immediately
sent Sandeep’s relatives back to fetch her peeled skin. Sandeep’s chacha Avtar
Singh, also the sarpanch of the village, raced to the village and got the two
pieces in a polybag. The doctors at the Civil Hospital put the pieces in ice
and advised Sandeep’s family to take her to Dayanand Medical College and
Hospital. From there, they were referred to the Christian Medical College and
Hospital (CMCH), Ludhiana.
It had already been three
hours since the accident by then. Around 6.30 pm, renowned microvascular
surgeon Dr Abraham Thomas saw Sandeep for the first time. Over the next 10
hours, the surgeon and his team would reconnect Sandeep’s arteries and veins
with her torn skin.
Dr Thomas, who is now the
director of CMCH, was not sure Sandeep would survive the operation. No one
present surely imagined they were about to make history as the first reported
full-face replant.
A similar operation would be
conducted next more then two years later, in the Australian state of Victoria.
It would take another nine years for the world’s first partial face transplant
to be done, in France, while the first full face transplant would have to wait
till 2010, Spain.
In the section of the
surgical ward at CMCH with the very critical cases, Sandeep works quietly and
efficiently, adjusting the IV drip of a patient. In the third trimester of her
pregnancy, the staff nurse has been given “easier” hours in the colourful
paediatric OPD — located on the first floor of CMCH, just two floors down from
where Sandeep has spent a large part of her life as a patient.
Nursing superintendent Reena
Jairus is proud of her young ward. “Sandeep has details of patients on her
fingertips, she is skillful and communicative, and her attitude is very
positive. She counsels patients well,” says Jairus.
As for her past, Sandeep hardly discusses that, the superintendent adds. “The only time we spoke a little about her accident was when she sought leave for a week for a recontructive surgery.” Colleague Rose Mary, who used to work with Sandeep in the surgical ward, says the 30-year-old isn’t one to look for sympathy. “Once I asked her about the scars on her face. She just told me she had met with an accident at the age of nine. I never asked her anything after that.”
As for her past, Sandeep hardly discusses that, the superintendent adds. “The only time we spoke a little about her accident was when she sought leave for a week for a recontructive surgery.” Colleague Rose Mary, who used to work with Sandeep in the surgical ward, says the 30-year-old isn’t one to look for sympathy. “Once I asked her about the scars on her face. She just told me she had met with an accident at the age of nine. I never asked her anything after that.”
After the surgery in 1994 and
through the years of recovery, Sandeep was never in doubt that this was where
she would head after growing up.
In 2004, she took admission
in a Punjab nursing college. When Dr Thomas moved south as principal of the
prestigious Pondicherry Institute of Medical Sciences (PIMS), she shifted
there. Since she needed successive recontructive surgeries to reduce her scar
lines, this was agreed upon as the best course.
The doctor returned to CMCH
in 2008 as director, and the next year, Sandeep, after completing her nursing
degree, joined as a staff nurse at the hospital.
Says Jairus, “Most of the
staff knows about Sandeep’s surgery. But it can happen to anyone; it was just
an accident. Sandeep is like any another nurse.”
In the days that followed the
July 1994 operation, Sandeep’s recovery was good, but unpredictable. “The
doctors first re-attached the right part of the face, and then the left. Both
started receiving good blood supply within three days; Sandeep responded well.
Our daughter was back,” says Saudagar Singh.
Hailing the “miracle”, he
adds, “At the time of the accident, my family or the villagers had no idea what
to do with Sandeep’s torn skin. They left it at home thinking it was useless; a
few even advised that it be thrown away. Thank God, we did not do so.”
Sandeep stayed in hospital for two and a
half months. In the first 45 days, she could not speak or see, with stitches
all over her face. Saudagar gave her a small notebook, in which she would
scribble what she wanted to say or whom she wanted to meet. She would identify
her visitors by touch.
Sandeep was also kept on IV
fluids and had to take medicines by injection as she could not eat or drink.
Even when the stitches came off after one-and-a-half months and she could see,
she was still not allowed to eat or talk much.
It was by end-October 1994, that she finally started speaking and eating normally.
It was by end-October 1994, that she finally started speaking and eating normally.
Within days, Sandeep recalls
proudly, she was back at school. “I used to go to her home as well to teach
her, and she picked up things fast. She stood first in Class IV like previous
years. We are all proud of her,” says Parkash Singh,one of Sandeep’s teachers
from then.
Her face was badly scarred at
that time, and Sandeep admits many children couldn’t help but stare at her.
However, soon, she said, they were treating her like any other child.
