Honduras: Day 2

Source: Blog Post

Contributors: Dr. Cody Hillin  

After screening 139 patients in clinic yesterday, we were ready to tackle our first OR day. Our efforts were fueled by the remarkable buffet at the Intercontinental Hotel. After breakfast, our bus maneuvered through the maze of city streets (without traffic lights) to the Ruth Paz Hospital. We set about our various tasks to get the day going: seeing and consenting / marking our surgical patients, organizing our instrument and implant sets for each OR, and meeting to do morning board rounds with all of the hospital OR staff. We were worried initially as we heard that 5 of our patients had failed to show up, but fortunately all but one eventually made it in for their procedure.

Dr. Leversedge leading the OR team through the schedule for the day.

The day began with bilateral carpal tunnel release, a distal phalanx amputation for recurrent glomus tumor, a glomus tumor excision, and a small-ring finger syndactyly reconstruction.

A 22 month old, undergoing 4th webspace reconstruction.

The next wave of cases included small finger burn contracture release and z-plasties, a long and ring finger webspace reconstruction revision, a distal radius open reduction and internal fixation, and an open shoulder reduction for chronic dislocation. The shoulder had been dislocated for 4 months ... but this was a warm-up for the patient later this week with a 6-month shoulder dislocation.

Our Touching Hands portable ultrasound allowed Dr. Juli Hobbs, one of our anaesthesia team, to place brachial plexus and peripheral nerve blocks expanding the options for pre- and post-operative analgesia.

The next wave of cases included an open chronic rotator cuff repair, middle and ring finger proximal phalanx nonunion revision open reduction and internal fixation, a ring finger MCP amputation with scar revision and z-plasties.

Each of our two operating rooms had two tables to facilitate concurrent cases.

The last set of cases included a middle finger flexor tenolysis with volar plate repair for a chronic swan neck deformity, a carpal tunnel release, and a ring finger distal interphalangeal joint fusion.

As the day wrapped up, a difficult tenolysis in a patient with a swan neck deformity brought the entire team together to observe and offer suggestions demonstrating the rapid development of teamwork.

Once the OR day was complete, we were able to enjoy some local fare at the Arab Club and were surprised by a mariachi band - a great celebration of our first surgical day.