After the Kahramanmaraş-centered earthquake, thousands of citizens were left under the rubble and many health problems were experienced. Many people, including young people and children, had to have their arms and legs amputated due to crushing under the rubble. prof. Dr. Evrim Coşkun said that the wound treatments of the patients whose limbs had to be amputated in various hospitals after the earthquake still continue, but that the real need for prosthesis for many citizens, including young people and children, will begin to emerge after 2-3 months.
PROSTHESES ARE MADE ACCORDING TO SPECIAL SIZES AND NEEDS
prof. Dr. Coşkun emphasized that prostheses applied after limb loss are not standard devices that can be bought from the market as such, and emphasized that they are made according to individual dimensions and needs. Considering that the prices of some prostheses can reach hundreds of thousands of TL, Prof. Stating that in such a great need that will arise, this process may not be overcome only with the SGK reimbursement system. Dr. Coşkun noted that non-governmental organizations, holding, orthotics and prosthetic companies should also take responsibility in this regard.
prof. Dr. Coşkun said, “As physiotherapy and rehabilitation clinics, we will have great things to do for a very long time after the first days of the earthquake. Earthquake victims may experience fractures, head traumas, paraplegia due to spinal fractures (spinal cord paralysis), tetraplegia (loss of movement in arms and legs), or amputations that occur after crushing a limb. After the first surgical interventions, the treatment for this falls to us, the physical therapy clinics. We have a brand new patient group ahead of us, which we will experience for many years to come,” he said.
“WE ARE YET IN THE PHASE OF WOUND CARE”
Stating that the problems of sheltering, eating and drinking and safe living space are at the forefront for earthquake victims at the moment, orthotics and prosthesis needs will come to the fore for the injured in the chronic, that is, long-term period. Dr. Coşkun said, “Orthoses are the devices that will support that body part, that is, the arm, the leg, while the person has a body part. But if the person’s arm or leg was lost by amputation, a prosthesis should be applied instead. After the first surgical intervention is performed in amputated patients, after they heal with wound care, we enter the process of preparing these limbs for prosthesis. In the first place, we pass the joint protection and muscle strengthening phase. Then there is the application of prosthesis,” he said.
“IT IS NOT STANDARD SIZE PRODUCTS, IT IS CUSTOM MADE”
The price of prostheses, which can enable the person to continue his life in the most normal way and to continue his life almost without feeling the absence of his limbs, can also vary according to their characteristics. The price of some prostheses can reach hundreds of thousands of liras. Emphasizing that prostheses are not something that can be bought from the market, Prof. Dr. Coşkun continued his words as follows: “These are not standard products such as xs, medium large or size 36-38. They are devices that should be made for the person’s needs, age, profession, expectation and social life. There will be such a diverse range of prostheses and orthoses that they must be evaluated and made according to the needs of the person. It should be neither below nor above the person’s needs. We have patients who have gone to an amputation level that is much higher than expected. SSI may not be able to meet all of these, or the standard system provided by SGK may not be suitable for every patient’s needs. Sometimes the need of the person can be far above this standard. In these cases, non-governmental organizations, certain holdings and aid organizations will have to take responsibility.”
“CHILDREN CAN ADAPT VERY QUICKLY”
Emphasizing that some patients may need very advanced prostheses, Prof. Dr. Coşkun said, “For example, in upper extremity arm prostheses, even prostheses with 2 processors and 4 processors can be mentioned. There are prostheses that can enable the person to maintain his daily life very well. It is really sad that our wounded children have encountered such a tram at a very young age. But children have an advantage, they can adapt very quickly. With the prosthesis that can be made suitable for them, they can continue their lives much faster than adults. That’s why we need to take action as soon as possible to complete the shortcomings of these patients such as orthoses, prostheses, and wheelchairs if necessary. The biggest problem for children is the need to renew and revise the devices they use as they grow up. We will need to take urgent action regarding this,” he said.
HIGH POSSIBILITY OF WOUNDS AND INFECTIONS
Noting that most of the amputation surgeries have just been done at the moment and that after the wound healing is achieved, the stage of “stump preparation (rehabilitation of the remaining part of the limb)” will be started, Prof. Dr. Coşkun concluded his words with the following warnings: “The fact that the stump has been made suitable for amputation and prosthesis use. We are at that stage at the moment. We cannot start the preparation of the stump and the use of prosthesis before 1 to 3 months. Because in these patients (since most of them emergency surgery is performed), there is a high probability of infection at the wound site and it is necessary to prepare it because it is a traumatic amputation. Also, it takes a little more time because most of our injured people have kidney problems, head traumas, other health problems, not just amputations. But we have to take action as soon as possible, without waiting for this process. Our applications have started Both Physical Medicine and Rehabilitation We are exchanging ideas on what can be done in this regard in the Iitation Association and on the platforms where orthotics-prosthetic technicians are present.”
(DHA)