Wounds treated for 5 hours and put for more than 150 stitches: how to erase "marks of war"
The 34-year-old dentist was at work and was severely injured during the missile attack on Kyiv on January 2. Now he is undergoing treatment at a dermatology clinic - doctors are making his rough scars softer, relieving itching and redness. As part of the Zahrava program, the victims receive such treatment free of charge.
Every time an enemy missile arrives somewhere or the wreckage of a downed missile falls on civilian buildings, we monitor whether there are any victims, how many, their age and severity. But there is so much information like this that there is not enough time to track what happens to those who suffered severe consequences. A battered country, buildings, people... We hear that there are programmes to help overcome the consequences of injuries to soldiers who have lost a leg or arm. We know that modern prostheses are made for them and they are taught how to use them. But those who have suffered facial injuries and have scars growing over their skin also need to be taken care of. And this help is provided free of charge.
THE VICTIM'S WOUNDS WERE TREATED FROM 10 TO 15 O'CLOCK, THERE WERE SO MANY OF THEM
The man takes off his T-shirt and lies down on a chair that looks very much like a dental chair. His arms, chest, neck, and face are almost completely covered with red scars. The doctor carefully examines the biggest ones. "I can see that it is getting better. The scars are becoming flatter," I can hear the satisfaction in Olena Oleksandrivna's voice. The patient confirms that he also feels better. Only the itching does not let him rest. "Now we're going to have unpleasant injections again," the doctor warns. And he starts injecting the medicine directly into the scars.
- "The drugs we use to restore the skin structure from the inside," explains Olena Hrysha, a doctor at Averina Clinic in Kyiv, "They also have an anti-inflammatory component. We perform similar procedures on Yevhen once a month and monitor the dynamics of scarring. Our task is to make hypertrophic phenomena normotrophic. What does this mean? It means that the scars, which after wound healing turn red, rise above the skin, tighten the tissues, become elastic, and stop inflammation... This patient has already seen improvement. Unfortunately, he is not the first one. During the two years of the full-scale attack, we have seen enough of such victims. As a rule, we help people after burns, mine-blast wounds, cuts with glass and plastic. This is the specificity of our clinic - to correct dermatological and aesthetic defects.
...Yevhen was injured on 2 January this year. Then, during a massive attack, one missile managed to break through our air defence and hit a civilian building on Kudriashova Street in Kyiv. Forty-nine civilians were injured, two were killed...
- The first floor of this building was used to house a dental clinic. "I have been working there since 2015," the man says. "In 2022, we had a three-week break, and on 20 March we started seeing patients again - one of the first in the Solomianskyi district of the capital. At first, I went to a neighbouring region, but soon returned - patients were calling and I had to get back to work. During this time, there were hits near us more than once. Sometimes we even closed down, but not for long. Over time, we got used to what was happening. We followed safety measures but continued to work. There are a lot of people in the city and they need our help. So we worked.
On 2 January, I had just arrived at work. I hadn't even entered the clinic yet - I was drinking coffee at the entrance. I heard the air raid alert clearly. Before I could figure out where to go for shelter, the clinic door blew open and crushed me. I was unconscious for seven minutes. When I recovered consciousness, the ambulance had already arrived. I felt like my left side was cut. I couldn't see out of my left eye - it was flooded with blood. I tried to wipe it off, but my hands were terribly dirty. I had nothing else to wipe my face with. I realised that something had hit. There was smoke, debris, glass all around. I got out from under the door, "adjusted my sights" and went to the nearest ambulance. The police helped me get there because I could have hit a tree. The strangest thing was that I didn't feel any pain at all.
The man was taken to the hospital, and where the wounds were treated there from 10 a.m. to 3 p.m.- there were so many of them.
- "They called an ophthalmologist," Yevhen continues, "He treated my eyelid. At the same time, they found out that the shrapnel had severed the radial artery in my arm - you can see a large scar formed in this area. In a way, I was lucky because the shrapnel itself blocked the artery. Otherwise, I would have bled to death.
Yevhen spent 18 days in the 17th hospital in Kyiv. Other victims were taken there as well during the explosion.
- I was injured mostly by glass," says Yevhen. "Small tubercles were in the places where the glass was stuck. Over time, it came out of my body by itself... I was discharged from the hospital without having all the stitches removed, and I had over 150 of them... But at least the crusts from the wounds started to fall off. My face was asymmetrical - there was still swelling. I had two surgeries on my eyeball - one of them resulted in the replacement of the lens. Over time, I began to notice how keloid scars were forming on the site of the scars - red, ugly, large
Despite everything, Yevhen returned to work in April. It was the patient who advised him to go to the Averina clinic - she had heard that they help treat scars.
- "The hardest time for me is in the morning," says Yevhen, "I feel like the whole skin is tight, burning, itchy. As a person involved in medicine, it was clear to me that it was necessary to restore the elasticity of the tissues. And if nothing was done, it would only get worse. When I was asked in the clinic what was bothering me, I said: everything is bothering me! Of course, I would like everything to go back to the way it was, but it's not going to happen. It's obvious.
As of now, Yevhen has already undergone four treatment procedures. Special medicines are injected into his scars. But in each case, a different treatment is prescribed. It depends on how the patient got the scars.
"WE WILL WORK UNTIL THE NEED FOR OUR HELP DISAPPEARS"
- "I wanted to help the wounded, to do something for the affected people. Although I am a dermatovenereologist, my experience could also be useful," says Vladlena Averina, a dermatovenereologist, founder of Averina Clinic and the mastermind behind the Zahrava project. "Our first patient came to us in May 2022, after being recommended by doctors at a hospital in the capital. She and her family came under fire when they were trying to leave Chernihiv. Her relatives were killed in the car, and she covered her child. As a result, the woman was thrown out of the car by the blast wave. Her face and arms were injured, and her retina was torn. She was looking for help. And we did everything we could for her. After our joint treatment with the ophthalmological clinic in Chernihiv, her appearance became better. After that, the information that you can get free dermatological rehabilitation began to spread among patients and doctors alike. In addition to wounded civilians and soldiers, we were also approached by colleagues in different cities of the country who were also ready to help with treatment, as well as representatives of companies to provide medicines to such patients.
That's how the dermatological and cosmetic care network began to form, and in August we created a website to provide a single place to find information about everyone who is ready to provide specific but much-needed treatment. That's when the name of the project, Zahrava, was born. Back then, in 2022, 11 clinics across the country were united. We cooperate with other powerful organisations that provide assistance to the wounded, including psychological support. After all, our patients often need the support of psychologists. Last May, we held a conference dedicated to the issue of scars - Scar Conference. This is the main problem that worries the wounded. And there are different approaches to their treatment. That is why we discussed with experts when to use a laser, when reconstructive, plastic and other surgical interventions are necessary. Scar treatment usually takes 6 to 12 months. It's a long process, but it has an effect. And the wounded should know that they can get this kind of help.
At the moment, there are 57 participants in the programme. 90 per cent of them are dermatological clinics. At the end of June, we will hold a conference at the Institute of Traumatology. Not long ago, Games of Heroes joined us. People with amputations often have problems with their residual limbs - we try to help with these issues, because sometimes scars do not allow the wounded to have normal prosthetics, and we can help in these cases as well.
During the conferences, psychologists tell doctors and, above all, clinic administrators how to work with such victims, because they are the first to communicate with patients and answer their questions. By the way, the main thing that worries affected people is whether the help is really free. Many people think that the first procedure will be free, and then they will have to pay. But within the project, all treatment for war victims is free of charge. Moreover, we also provide medicines for home treatments at the expense of companies that have joined our initiative.
The wounded usually "open" during the fourth or sixth visit. They begin to talk about themselves, share their impressions, and evaluate the results of treatment. This happens when they are convinced that they are really cared for. The military is especially inside. When they come to a cosmetic clinic for the first time, their faces literally say: what am I doing here? But facial injuries, scars, scars are not just an aesthetic problem. Psychologically, it is also difficult for a person to see how they have changed overnight... And when we intervene, correct scars, reduce visible traces of injuries, it becomes a little easier for our patients to look in the mirror and communicate with the outside world.
Over the two years of full-scale war, the Zahrava project has conducted more than 1,200 consultations. 620 wounded were treated. 50 patients were referred to other specialists, where they received the help they needed. Doctors were also trained.
- Some people have a tendency to develop hypertrophic and keloid scars," continues dermatologist Vladlena Averina, "They develop if wounds do not heal for a long time, in places of tension, if hardware treatment lasted a long time - the bones were fixed with external fixation devices. Physical therapists know how to work with such scars, how to stretch and twist them, and what to use. This is why it is necessary to train colleagues in different clinics.
Now we work more with the military than with civilians. Although at first, we were approached mostly by ordinary people affected by the war. For me personally, the case of a teacher from Kupiansk was illustrative. She taught Ukrainian language and literature. When she was leaving the city, a shell hit her car. Her face and head were cut - large areas were affected. But she continued to teach after leaving the city. And it became stressful for her every time because half of her face was badly damaged. When she came to us, she was wearing a hood, and it was pulled down so deeply that the light did not hit her face... The woman had not dyed her hair for several months. Our treatment helped her. And after several treatments, the teacher told us that she had finally bought a mirror, and then we saw for ourselves that she had dyed her hair and made a hairstyle. These were obvious changes. Both aesthetic and moral and psychological.
We try to tell people about our work, but most often it's word of mouth - someone told someone. Half of the wounded who come to us for treatment have been told about our work by someone. Currently, 75 per cent of those receiving help in the programme are military personnel. How long is our program planned for? We will work until there is no longer a need for our help.
Our experience is of particular interest to doctors abroad. When we organise conferences in Europe or when one of our Ukrainian specialists makes a presentation, the halls are full, and people even stand outside. Every year, Monaco hosts the AMWC, a major international congress on age-related medicine, and for two years in a row, Zahrava has been organising sessions on scar treatment. In Italy and the UK, we organise joint webinars, because doctors there are very interested in hearing from us about rehabilitation. We also exchange experience: in Thailand, a professor of dermatology and laser medicine at a university clinic arranged an internship for Ukrainian doctors so that they could learn modern laser techniques and then use them in extremely difficult cases.
You know, the main slogan of our project is "We erase the marks of war". This is our goal - to minimize the reminders of what happened, to remove those scars that are unpleasant to see in the mirror. We cannot erase memories from a person's memory, but we can make it easier for them to look at themselves.
The phone number to get information and make an appointment for a consultation in the city that suits you best: 067 749 23 05.
The website where you can submit a request for assistance and find out about the clinics that provide assistance: zagrava.info
Violetta Kirtoka, Censor.NET
