A team of doctors at Tiruchi’s Apollo Hospital has been successful in treating a severely injured road accident victim in a collaborative effort of surgical procedures and post-operative care.
At a press conference held by the hospital on Saturday, the medical team, consisting of 15 consultants, discussed the critical case and measures taken to minimise the effects of ‘polytrauma’ — a term that refers to the precarious condition of a person who has been subjected to multiple traumatic injuries.
The patient, Vijaykumar, a businessman in his 40s, met with an accident on the outskirts of Karaikudi on March 10, when the car he was driving overturned and he was thrown out nearly 30 feet away from the vehicle.
“The patient was brought to Apollo Hospital in a minimally conscious state, after being initially treated in Karaikudi. He had suffered multiple bone fractures, brain-focal frontal haemorrhagic contusion and his right pelvic bone had been dislocated. Besides this, he had multiple deep contact burn wounds in the right arm and thighs. His low blood pressure did not give much hope,” said Mayilan Chinnappan, consultant neurologist, who led the team.
The multi-disciplinary group planned the stages of surgical intervention for other injuries, while pelvic dislocation was attended to by close reduction (a procedure to set a broken bone without cutting the skin open) by Dr. Balasubramanian.
Orthopaedic consultants K. Balasubramanian and Arun Geethayan did the surgery to fix the patient’s left femur and radius injuries.
However, the situation was further complicated when the patient developed acute kidney injury and chronic liver failure. The issue was attended to by gastroenterologists SNK Chenduran and Murali Rangan. “Besides all the operations required for the accident wounds, the patient was suffering from jaundice due to liver failure. We had to delay some surgery in order to let the liver recover first,” said Dr. Chenduran.
The burns wounds and the skin inflammation on the patient’s thigh became infected with mucormycosis. “We had to carry out aggressive debridement to remove the damaged tissue, and eventually nearly one-third of the natural flesh of the patient’s thigh had to be replaced with skin grafts through plastic surgery,” said Dr. Vidhunraj, plastic surgeon.
After two weeks of sepsis, pneumonitis, dyselectrolytemia, metabolic encephalopathy due to hyper ammonemia, the patient started showing signs of recovery in the metabolic state.
Intensivists Barani, Vignesh, Muthu Venkatesh and Kumar; Anaesthesiologists Karthik, Saravanan and Azhagappan and neurologist Kevin Joseph were among the other consultants involved in the multi-modal procedures.
“It has taken us at least six weeks of rehabilitation to help the patient come back to a near-normal state. He may not be able to walk for a year, as his operated leg is not strong enough to bear his weight, but with physiotherapy and a regulated follow-up, we are hopeful of him regaining his health,” said Dr. Mayilan.
