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Doctors save the face of man crushed by toppled tractor

Doctors save the face of man crushed by toppled tractor

Sagaya Fernando
Mumbai: 2 April 2020

Kisan Pawar

For 36-year-old Kisan Pawar, driving a tractor and ploughing his field on his farmland in a village in the outskirts of Baramati town in the state of Maharashtra, India, was like any other normal day on March 25. However, while turning the tractor at the edge of his farm, he ran into trouble as the tractor went off-balance and overturned, and he came under the rotating plough which instantly crushed his face, tearing off flesh and squashing facial bones. His horrified family members and others working in the field rushed him to the nearest medical facility – Anuchandra Hospital at Baramati.

Seeing the condition of Pawar, the doctors at Anuchandra Hospital felt the need of an expert surgeon to conduct the surgery to save his face. Accordingly, they contacted specialist micro-vascular surgeon Dr Abhishek Ghosh at Pune city, around 100 kilometers away. Dr Ghosh has performed many similar complex surgeries, one of them being the reattachment of the hand of a 4-year-old boy by a grass cutter, in early February.

The doctor from Baramati contacted me and told me about the patient. He told me that the patient was not very affording and will be unable to afford the cost of big hospitals in Pune. Also, it would be very difficult for the family in the lockdown period (to contain spread of coronavirus) to manage everything. So, it was decided to operate him in Anuchandra Hospital at Baramati itself,” informed Dr Ghosh.

“The patient was already put on treatment to reduce the swelling and surgery was planned for March 30. I travelled to Baramati which is around 100 kms from Pune in the morning. A tracheostomy was done first, then the patient was given anesthesia and surgery was started,” he added.

The complex surgery to restore his facial skeleton took around 7 hours. 

“His entire facial structure was distorted and facial bones were in pieces. What made it more difficult was that all the bones in the midface were crushed and in small pieces. There was no support to the face. Both the orbits had blowout fractures with herniation of the fat in the sinus. The nose was completely open and was open to the sinus. The palate was also in two pieces. Even the mandible was fractured,” said Dr Ghosh.

He further added, “First the mandibular and maxillary alveolus was got into alignment. The mandible was fixed with plates and screws. Then painstakingly the vertical and horizontal buttresses of the face were reconstructed one by one. Then the orbital blowout was repaired and plated. Finally, the soft tissue of the lips and nose were reconstructed.”

The patient is now recovering well. The soft tissue wounds would heal in a two to three weeks. The bony skeleton is expected to heal in two to three months’ time.

“The external appearance of the patient will improve with time as swelling reduces. The bony alignment has come good,” said Dr Ghosh.

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