Wellness & Fitness

Doctors champion smart way of managing wounds

hosi

Patients at a Hospital. FILE PHOTO | NMG

In 2014, just after completing secondary school, Jacob Owiti took up a job as a motorcycle rider in Western Kenya to raise money to enable him seek formal employment in Nairobi.

But after only three months into the job, Mr Owiti was involved in an accident with a lorry as he was ferrying goods on the motorcycle. The severe injuries sidelined him for about two years.

Health experts are concerned that such motorcycle accident injuries have been on the rise since the government authorised the use of motorcycles as a means of public transport about a decade ago.

“The idea was well intended. It was aimed at creating economic activities for young people. But this has created a major health problem that tends to affect the youth at the early stage of their economic life,” said James Mogire, a consultant orthopaedic at Kenyatta National Hospital.

Unlike vehicles that have safeguards such as air bags which can cushion passengers from adverse effects of accidents, Dr Mogire noted that motorcycles are open, with nothing to create a barrier between riders and an object when they collide.

“This leads to direct exposure to trauma for both riders and their passengers. If they fall, it will be their body against the tarmac or any other object. And this causes bad injuries,” said Dr Mogire.

Aside from fractures, muscle tears, neurological disorders and severe head and neck injuries, victims of motorcycle accidents suffer from massive wounds that are difficult to manage as they are prone to infections and may take long to heal.

They also have to endure long hospital stays, suffer from immense pain and incur financial losses while they are bedridden at health facilities.

Due to the severity of the wounds, affected body parts such as legs may end up being amputated if accident victims fail to get timely care or visit facilities in rural areas that may not be well equipped to handle such injuries.

“So you can imagine this is a young person that had his entire life planned. But now he will be unable to ride his motorcycle or perform other economic activities well. This can be devastating for the victim and his family.”

To hasten the recovery of such patients, health experts are advocating the use of an innovative technique known as negative pressure wound therapy (NPWT), which is effective in tackling chronic or difficult to manage wounds. “This therapy cures such wounds faster. It halves the healing duration, thus enabling patients to get well faster than would have been the case with standard care,” said James Kigera, an orthopaedic surgeon and vice- chairman of the Kenya Orthopaedic Association.

Unknown to most people, the different gases in the air around us put pressure on the surface of our bodies, which adversely affects wounds.

The new therapy addresses this challenge by helping to decrease the amount of air pressure on the affected area.

Need quality care

The NPWT device comes with dressing material, which is put directly on the wound.

This is followed by an adhesive cover that is used to seal the dressing and the wound to create an airtight environment in the affected area.

A pump connected to a drainage tube (placed under the adhesive cover) is then used to remove air pressure on the wound.

It also drains fluids from the affected area, thus helping to remove bacteria from the wound so as to curb infection. This hastens the healing process by increasing blood flow into the affected area, reducing swelling and stimulating the growth of new tissue that helps the wound to close.

Despite its proven benefits, the therapy is mainly available in private hospitals as it is unaffordable to most Kenyans. Each treatment session costs about Sh35,000.

The huge cost is largely driven by high-end commercial varieties of NPWT units that are often used in private healthcare facilities.

But a new paper published in the current issue of the Annals of African Surgery journal shows that healthcare workers can lower the cost of this technology by replacing its high priced commercial components with local low-cost products present in most hospitals such as cotton gauze swabs, adhesive film covers, naso-gastric tubes and suction machines that are often used for a myriad of other health procedures.

Dr Kigera, who is also editor-in-chief of the journal, noted that such modifications could greatly reduce the cost of the therapy to about Sh600 down from Sh35,000 thus making it accessible to most Kenyans.

“We have very many people with severe wounds that need quality care. So the technology shouldn’t only be a preserve of a few people who can meet the high private hospital costs.”

Aside from severe motorcycle injuries, the NPWT is also ideal for treating other chronic wounds caused by second and third degree burns as well as injuries occurring among diabetic patients that are usually difficult to manage.

According to Dr Kigera, modification of such health technologies will enable Kenya to effectively decentralise wound care thus saving patients the agony of being transferred to large hospitals in urban centres that may not even have space to accommodate them.