Nordic Life Science 1
UKRAINE // COMMENTARY After 18 hours of traveling
from Gothenburg I'm heading to the main hospital in Cherkasy, Ukraine, which is a reasonably-sized hospital with about 800 beds. Apart from their everyday business they have had an extra about 30,000 or so soldiers to take care of since the war started. They are worn out. The staff members are really trying to hang in there. They're running low on supplies but they're not giving up. T E X T B Y R I CK A RD BR Å N EMA R K, CH I EF MED I C AL AND SC I ENT I F IC OF F IC ER , I NT EGRUM I 'M HERE BECAUSE the need for healthcare is hard to overstate. From a clinical and surgical perspective, Sweden is ahead globally and the technology I'm bringing – an advanced osseointegration treatment for amputees with very short remaining stumps – is a true Swedish innovation that is much needed here right now. The healthcare system in Ukraine is under enormous pressure. What I see isn't a shortage of surgical skills, Vlad and his colleagues are very capable. It is the harder, less visible problems: keeping hygiene and infection control under wartime conditions and having enough trained staff that can follow the procedures to reduce problems with infection further. That has a direct impact on our implant work – anchoring titanium through the skin demands clean conditions and disciplined aftercare. I'm traveling together with a colleague from Karolinska University Hospital and our mission is to train the medical director of the hospital, Vlad, to be able to perform an improved rehabilitation procedure for amputees. There are really no official figures for the number of amputees from the war, but Vlad says that it's more than a hundred thousand who have lost arms or legs. A major problem here is that they will survive the blast injury, because they have body armor, but the blast injury will start bleeding from their arms and legs, and they activate the tourniquet so as not to bleed to death. Unfortunately, it might take hours and even days until someone can evaluate whether the tourniquet can be released or not, by which time the arm or leg is already dead. These devastating amputations make it very difficult to supply the prosthesis since there's really no arm or leg left to attach the prosthesis to. However, with the technology developed in Sweden, we now have the possibility to anchor a titanium implant in the short remaining skeleton that exits through the skin and acts as a perfect anchoring point for a prosthetic device. NORDICLIFESCIENCE.ORG | 41