Week of Amputations

(C-130)

WARNING: This blog entry contains some graphic surgical photos. Proceed at your own risk. Picture # 1 is an Air Force C-130. These planes are the work horse of the military and provide troop and supply transportation all over both theatres of war.

Last week ended with a bang and this week began with one. On the receiving end were many of the local nationals that live nearby. After nearly 30 years of ongoing war, Afghanistan has become heavily populated with land mines. Anyone walking through this country is at risk of encountering one. Recently we treated 3 young men who were on vacation near Khost that happened upon a land mine. Picture # 2 demonstrates the devastating injury that occurs to limbs involved. You should also note how incredibly dirty the leg is. He was taken to the OR where the injured remnant was removed and the wound thoroughly washed (picture # 3). These types of wounds require multiple trips to the OR for washout of the wound before definitive completion of the amputation.

(Washout)

We also dealt with several IED extremity wounds this week. Early this week the Taliban detonated an IED that hit a passenger bus (See New York Times). We received many patients who were seriously injured. As a recurrent theme, someof the injuries involved the lower extremities (picture # 4). These individuals were also taken to the operating room for removal of the destroyed tissue and washout of the wounds. Over the course of the next several days they would be taken back to the OR for additional cleaning. Once the wound were considered clean and no further tissue loss is noted, they are finally closed (pictures # 5 & 6). I know that much has been written about the incredible work with prosthetics that is happening for soldiers in the United States who have these same types of injuries. Unfortunately, a prosthetic limb is a luxury only few of those injured in Afghanistan will obtain.

(Dressings)

(Completed amputations)

We ended the week on a bright note. Because time is really all we have while deployed, many people spend it on academic endeavors. In fact, there are multiple classrooms here on base, and some soldiers can take offered college credit courses while here. Others participate in web-based courses, for example, Dr. R, the orthopedic surgeon is completing an MBA. On Saturday and Sunday I took a Pediatric Advanced Life Support (PALS) class. It was taught by 3 certified instructors and included both didactic and hands-on training, complete with a “megacode” scenario performed on a computerized mannequin (picture #7). I am now PALS certified. Not a bad way to pass the time. Sunday evening, we were invited to one of the Special Forces (SF) compounds on base for a bar-b-que. Some of the local Afghans that they work with cooked up some local dishes. It was delicious and included, fresh fruit, batter fried vegetables, flat bread, beef kabobs, fried chicken, rice, and a variety of dipping sauces. It reminded me of Indian food. Jeff, one of the SF medics celebrated his birthday (picture # 8). Take care.

(Happy Birthday Jeff)