PEDIATRIC PLASTIC SURGERY:
IS IT A FIRST IN OUR COUNTRY?
Children are a
distinct group of patients who deserve special skills in their treating surgeon
to remedy their imperfections. The advance in paediatric anaesthesia has made
long strides in making surgery safe in even a newborn. Avoidance of surgery
leaves tell tale signs and leaves scars on the psychology of the child which
cannot be corrected by surgery performed at a later date.
The discussion
on robotics in surgery, reimplantation of limbs and body parts by micro
vascular surgery, age-defying surgical manoeuvres like body contouring; sound
irrelevant when the common man instead of approaching a trained physician
consults the local pharmacist or the famous baba who has the bakshish to cure
all ills. The worst affected are the tiny tots who haven’t even learnt their
first words and are suffering from ailments that the untrained hand will only
aggravate rather than providing succour.
It was Dr. C.
Balakrishnan, the founder father of Plastic Surgery in our country in the late
1960’s who laid down the firm foundations of Paediatric Plastic Surgery by
imbibing all his students that the work of a plastic surgeon is to undo the
deformities of birth and allay the ordeal of the populace of children who are without
a voice and to correct the fundamental deformities before they leave indelible
marks on their minds.
The gamut of
diseases that come under the preview of a pediatric plastic surgeon are
afflictions of any and all body parts from the head to the toes. A visibly distressing
Giant hairy nevus on the face of a
child, a cleft (split by birth) of
the lip and palate or a red bulbous
spongy growth of tumor like hemangioma,
Congenital deformities of the hand like syndactyly
(jointed fingers), polydactyly (more
than 10 fingers), macrodactyly
(abnormally large fingers), thumb
deformities carry a lifelong burden of disability and ridicule if not
corrected at the appropriate age of 1 year. Children below the age group of 5
years are the most common victims of sustaining injuries at home predominantly crush injury hand and scald burns. Emergent surgery, deft handling
of tissues, appropriate choice of suture material and appropriate dressings with
splintage are the factors that prevent the child from irrevocable scarring.
Deformities
like Hyospadias (abnormal opening of
urethra on the penis), skin tags
(especially infront of the ears), giant nevi (big black birthmarks), bat ears
(prominent ears), slurred speech due to tongue
tie (short frenulum on the under surface of the tongue), gynaecomastia (enlarged male breasts), torticollis (head tilted to one side);
prevent the child from socializing from the fear of being mocked at. A changed
behaviour after school is an indicator that the long neglected deformity by the
parents may be the perpetrator.
Unlike the
general perception of the general public Plastic Surgery Services are not
unaffordable to the masses. If Petrol changed from Rs 8/litre to Rs 73/ litre
in the last 20 years; a plastic surgeons fee has only decreased from Rs 50 per
consult to Rs 300 per week including innumerable free consults on the mobile
(Effectively Rs 42 per visit). It happens only in India..........
DR. ASHOK K. GUPTA DR. ASHISH GUPTA
FOUNDER & FORMER HEAD ASSOCIATE CONSULTANT
DEPT OF PLASTIC SURGERY & BURNS DEPT OF PLASTIC & MICROVASCULAR
D.M.C.Hospital, S.P.S. APOLLO HOSPITALS,
LUDHIANA LUDHIANA
TEL: +91-98155-00847 TEL: +91-977977-1111
