Hyena

Although Facing Africa was set up to deal with effects of the disease called NOMA, it is increasingly called on to carry out facial reconstructions for other conditions and one of the most common is hyena bites. These vicious predators will attack a grown human and have fearsome jaws which open wide and clamp shut around a skull.

Today's patient was this 5 year old boy who was attacked by a hyena a few months ago when playing outside his home. The hyena dragged the boy by his head for 300 yards and his mother, (seen here) ran after it and tried to wrest the animal off her son. Somehow the hyena let go, but it had taken off the boy's lower jaw, one of his ears and most of his scalp. 

The distraught parents took their son to three hospitals before they found one which would agree to operate.

Today Abel underwent a 13 hour operation to reconstruct his lower jaw.

The operation was made possible by modern technology. A new mandible was fashioned from his right fibula (leg bone) which was measured and cut using a plastic plate which had been computer generated from his CT scan and 3D printed in Switzerland. Skin from his leg was taken to cover the new jaw and a skin graft from his thigh to cover the defect. There were four surgeons, three anaesthetists and three scrub nurses working for the full 13 hours.

After the operation, his parents were able to see him settled in ICU for the night and tomorrow he will be woken up. I hope to see him up and about on the ward very soon.

Here you can see D putting local anaesthetic on Abel's hand so that he can have needles inserted painlessly :-)