- You are a plastic surgeon. How do the surgeries you perform in Lugansk differ from the surgeries you have performed for many years?
“For me, they are no different, except for the nature of the wounds.
Although wartime and peacetime injuries can overlap: I have had gunshot wounds in patients before and, conditionally, mine-explosive ones.
The purpose of operations is always the same - to eliminate the consequences of the pathological condition as much as possible.
Regardless, the injury is wartime or peacetime, or an injury inflicted on an oncological patient by my own hands.
The meaning is in the restoration, the return of a person to society, to the family in the maximum possible way.
— When did you decide to go to Luhansk?
- This happened at the end of February 2022, when the first data appeared with the features and characteristics of the existing injury.
I began to deal with this issue, since March I began to write appeals and meet people in order to get the opportunity to go there.
At first it seemed incredibly difficult.
I ended up having my first productive trip last June.
— Tell me, how often do you travel to Lugansk and how many people do you have in your team?
— Three weeks we work in Krasnodar and Moscow, and one — in Lugansk.
The number of doctors who go on business trips is constantly changing.
An average of four to seven.
© Photo from the personal archive
Do you bring equipment with you?
— We bring equipment with us and also buy all consumables.
We work there together with Luhansk doctors.
They have good skills, and, working in tandem for six months, they pulled themselves up so much that they routinized such surgery.
- What is this method?
Reconstructive surgery is a subdivision of plastic surgery.
If we talk about the top of reconstructive surgery, then, of course, this is autotransplantation.
When tissues are taken to restore a recipient defect not from a donor patient, but from the patient himself from other parts of his own body: limbs, internal organs of the body.
© Photo from the personal archive
Where did this treatment come from?
- From overseas colleagues.
As of February last year, I had about ten such surgeries.
And I gave the task to my students and doctors so that they conduct an analysis, a selection of the available medical surgical literature on the Internet.
We were looking for information on previous experience with such treatment in the early post-injury period.
We found articles detailing operations after wounds received by soldiers in Iraq and Afghanistan.
- Who are your patients?
— Speaking of reconstructive surgery in Lugansk, we treat absolutely everyone.
This includes the civilian population and the military.
We even treated a soldier of the Armed Forces of Ukraine.
He needed help, like all the other patients.
- What kind of injuries do you get?
- Most of the patients are people who have peripheral wounds of a mine-explosive nature of the extremities.
This is due to the specifics of military operations.
According to statistics, 96% of wounds in the bulk are mine-explosive, 4% are bullet wounds.
And accordingly, mine-explosive wounds, taking into account the presence of body armor and helmets, suggest the maximum damage to the limbs.
© Photo from the personal archive
— Can you tell us in more detail what kind of wounds you faced?
— There was a patient with a shrapnel wound of the chest, abdomen and pelvis with a deficiency of the soft tissue of the anterior abdominal wall.
Without reconstructive surgery, he actually had no chance of survival.
And now he is in rehab.
There were patients with facial wounds and damage to the lower jaw.
The nature of such injuries is tragic, because not only the appearance is lost, but also the function - a person cannot eat and talk normally, he completely drops out of society.
Another young man had a shrapnel wound to his larynx and was forced to walk with a hole in his neck and a tracheostomy.
He restored the respiratory and digestive tract, eliminated the tracheostomy, he breathes through the natural way.
He talks, returned to society.
In conclusion, I would like to say that in Krasnodar we operated on a patient with a progressive oncological disease from Donetsk.
She arrived in Krasnodar, where she was denied treatment in a number of medical institutions, because the disease was considered not subject to technical removal.
But we undertook and performed the removal of the tumor with a one-stage reconstruction.
© Photo from the personal archive
— Do you remember your first patient in Lugansk?
It was one of the commanders.
He is physically and mentally strong.
He listened to my version in the presence of other doctors who said that it was impossible to perform the operation technologically.
He said that he agreed to the operation.
- How did everything go?
- The first transplant, due to certain circumstances associated with the injury, did not take root in him.
We immediately took him to the operating room, took the second transplant and successfully completed everything.
He has fully recovered.
Have there been unsuccessful surgeries?
— In medicine, the effectiveness of methods is evaluated solely by time and statistics.
We operate on those people who, without reconstructive surgery, have a 100% chance of becoming amputees or permanently disabled.
Microsurgical operations are considered one of the most difficult.
According to general statistics, the risks of adverse outcomes in transplantation microsurgery in clinics with good experience operating around the world as a whole are about 3-7%.
If we talk about the statistics we received, we operated on about 50 patients, who had an unfavorable outcome only in two cases.
And then one of these cases was corrected - I'm talking about our first patient in Lugansk.
— How has your lifestyle changed since you started traveling to Lugansk?
“My vision of life has changed.
I sold an expensive car and stopped wearing custom-made suits.
I became content with little.
This applies to everything, including food.
When I saw what was happening there – I’m not talking about injuries now, because whatever they are, they cannot surprise a doctor – trips to Luhansk made me understand that the world is much simpler and should be much kinder.
© Photo from the personal archive
— What are your future plans?
- Train as many doctors as possible.
A month and a half ago, representatives of both First Med and one of the leading oncological research institutes began to contact me with a request to take young doctors on a business trip so that they could gain the very experience I was talking about.
The first doctors from research institutes will go to work on the next trip.
How long does it take to train doctors?
One brigade can be trained in three months.
Considering that I now have five doctors who are able to perform such surgical interventions, then we will simultaneously train five teams.
And accordingly, in geometric progression, the figure of 1 thousand brigades is not so difficult to obtain.
And I also want to build a large oncology dispensary.
So that not one stellar surgeon operates there, but teams of experienced doctors.