Page last updated at 23:04 GMT, Saturday, 14 June 2008 00:04 UK

Healing the wounds of China's quake

By Jane Elliott
Health reporter, BBC News

Earthquake victim
Young girl whose wound stump was traditionally treated
When plastic surgeon Waseem Saeed came across a little girl who had lost her leg in the recent Chinese earthquake, he expected a child terrified of doctors and in great pain.

This had been the kind of case he had seen in the aftermath of the Pakistan earthquake - where many children were subjected to the agonising daily ritual of having their bandages removed so the raw stump of their amputated limb could be cleaned.

But this little girl was sitting in bed reading a book and appeared to be in no pain.

Her stump had been treated with a traditional herbal remedy, and was showing no signs of infection.

Herbal remedies

Mr Saeed said he had been astounded by her condition.

"She had what we call a guillotine amputation, where they had cut straight through the thigh.

We have probably got a lot to learn from this type of medicine
Waseem Saeed

"We don't know why she needed her amputation, but these are excruciatingly painful injuries - painful to handle and requiring the restoration of skin cover over the raw stump to allow healing.

"I looked at her stump and there was no sign of infection, despite the injury being 12 days old and unhealed.

Operating in China
Mr Saeed (on the left) operating on an earthquake victim

"What she did have on it was a brown material. It was a Chinese herbal remedy, a compound.

"I just thought 'we have probably got a lot to learn from this type of medicine'.

"It would be good to know what the medicine was, but each individual practitioner has their own recipe handed down and they aren't disclosed easily I am told."

Aftershock scares

Mr Saeed, who works as a consultant plastic, reconstructive and hand surgeon at Leeds Teaching Hospitals, said he and his colleagues were based just 52 miles (85km) from the epicentre of the quake, in a hospital in Mianyang.

While they were there last month, the hospital where they were operating had to be closed down due to aftershocks, the worst of which occurred during an operation.

"We were operating in the surgical tower block, which was the only functional part of the hospital - another two thirds had already been closed down by the original earthquake.

"At the end of the working day there was an aftershock.

"I have been in aftershocks before, but this one was quite severe. It is a very weird experience because you are focussed on the surgery.

Waseem (centre) operating on a earthquake victim
The UK team worked alongside local doctors

"I didn't even notice the beginning of it, my colleagues had to tell me.

"Then the lights started swaying and then the whole building was swaying - that was quite scary.

"You have to get the patient off the table and you need to get everyone out.

"You have to get them into a state in which you can transfer them.

"I was exploring a nerve in a patient's paralysed leg at the time and close to the end of the procedure," he said.

Paralysis risk

Mr Saeed said the same team of doctors and nurses had all been to Pakistan after the earthquake there two years ago.

But he said the injuries they saw in China were significantly different.

"There are higher buildings in China, so we saw injuries consistent with either a jump or a fall, possibly reflective of the architecture of the building.

"If you jump from a height you land with all the energy on your heels or feet, so we saw a lot of heel and ankle fractures.

"There were also cases of patients landing with their legs slightly bent, so we had fractures to the thigh and knee bone.

Contrary to popular belief, most plastic surgeons do not spend most of their time beautifying patients
Waseem Saeed

"But the most tragic were those who had spinal injuries through falling or leaping.

"Here the vertebrae were crushed, with fragments damaging the spinal cord leading to paralysis.

"There were young people paralysed from either the neck down or the waist down.

"These were very upsetting and there was nothing we, or indeed our local colleagues, could offer them.

"In Pakistan the buildings were more low-level and the ceilings were built of heavy concrete and so you found direct crush injuries, trapped limb wounds with fractures and large areas of dead tissue. In some cases though we were able to salvage these limbs," he said.

'Restore and rebuild'

Mr Saeed said plastic surgeons like himself are a vital part of any relief effort.

"Contrary to popular belief, most plastic surgeons do not spend most of their time beautifying patients.

"What we do is restore and rebuild damaged tissues following birth defects, major injuries, cancer removal and, of course, following burns.

"After an earthquake patients can suffer severe crush injuries, in which the bones are shattered and the flesh and the skin are destroyed.

"If this flesh and skin is not restored or rebuilt, then infection can rapidly set in, leading to limb amputation and, in the worst case scenario, blood poisoning can lead to death.

"Our experience from two earthquakes is that you can save many limbs."


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