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Show Early Surgery Is Lifesaver for Infants, March of Dimes Medical Expert Says MARCH OF DIMF flpg mm mm IT ";B":T,,1 fill : "' h " i wmm 'if t m -m m KJIflf&l is; s; . :4 " :i . : ; :?Sil .: : l & : St !wSiiSS :i !! i '''"iiiiiiiiiiiiiiliiiiiiiiii i . !" ' ' iiiiii' ' " Dr. Anita Falla and one of her associates give a post-surgical checkup check-up to one of her patients who needed an operation because of a birth defect. By ANITA FALLA, M.D. Pediatric Surgeon, March of Dimes Birth Defects Center Babies' Hospital, Newark, N. J. Pediatric surgery has become be-come a life saver for thousands thou-sands of infants born with defects. Three out of four babies beyond, the help of surgery as recently as 20 years ago can now be saved. It is entirely possible that within ten years, infanta we cannot help today, will survive sur-vive because of techniques now being developed in such fields as fetal surgery, organ transplants trans-plants and microsurgery. Successful pediatric surgery often includes a race against time requiring perfect teamwork team-work among the surgeon and the many other medical specialists spe-cialists who are responsible for the life of an infant with birth defects. Tremendous strides have been made in the early and accurate ac-curate diagnosis of many of these defects: Action can now be taken almost immediately after birth to correct many conditions that not too long ago would have been fatal. A good example is the emergency emer-gency that occurs when a baby is born with a condition called esophageal atresia in which the passage from the mouth to the stomach is closed or completely com-pletely interrupted so that the child cannot get food into his stomach. If the pediatric surgeon sur-geon does not act very quickly, the infant will die. Most of these children can now be saved by a well-trained surgical sur-gical team with the best hospital hos-pital facilities at their disposal. The nationwide network of birth defects treatment centers financed by The National Foundation-March of Dimes has dramatically demonstrated the value of providing diagnosis diag-nosis and treatment through teams of specialists consulting together under one roof. The pediatrician and the pediatric surgeon may wish to call on the skills of many specialists to help the child with birth defects. These could include a plastic surgeon, an orthopedist, neurosurgeon, urologist, nurses and physical therapists for just one tiny patient. There might also be need for X-rays, braces, laboratory tests and a multitude of . other services. The X-ray facilities and laboratory labo-ratory personnel must be particularly par-ticularly skilled in working with premature infants and children. The newborn infant is a startling contrast in toughness and weakness. He is tough in that he has remarkable healing heal-ing powers because his cells multiply rapidly to repair tissues tis-sues after surgery. At the same time, a baby can become ill almost without warning and the disease runs its course much more swiftly than in an adult. Needless to say, great care must be taken with surgery on infants and children. We must always remember that a baby is a human being in miniature whose parts are diminutive and vulnerable. An infant is also particularly susceptible to surgical shock. His body temperature tem-perature has to be maintained at normal level every instant. Almost every drop of blood lost during surgery must be replaced, because an infant cannot afford to lose much of his tiny supply which totals only about a pint as compared with five or six quarts for an adult. Every baby presents a different differ-ent problem based on weight, measurements and rate of development. de-velopment. Surgical technique for newborn babies is as delicate deli-cate as that of a watchmaker, because tiny growing tissues must be guarded against damage. dam-age. Nothing can be squeezed or tied too tightly for fear of damage. Tension must be always al-ways avoided. Surgery is performed per-formed with the tips of the fin gers to achieve delicacy of touch. Everything used in pediatric pe-diatric surgery is in miniature. Surgical knives have blades no longer than half an inch. Tiny thermometers are used, blood tests are taken usually by the drop, and a blood transfusion may be only one or two ounces of blood. Infant heart-lung machines are available for open heart operations on babies and a small' blood pressure pres-sure instrument with a cuff an inch wide and only three inches long is wrapped around a baby's arm to measure his blood pressure. In so many ways it is difficult diffi-cult to operate on infants because be-cause of their tiny size and lack of resistance to infection. Often several different conditions condi-tions commonly found in infants in-fants with birth defects must be tackled together and at once in order to save the child's life. Action must be taken immediately even if the surgical team has to stay up most of the night in the operating op-erating room. After the surgery sur-gery is completed, the infant requires very careful nursing care. Given precise surgical treatment, and dedicated constant con-stant nursing care, the infant has an excellent chance to survive sur-vive and mature. One must always al-ways realize the infant's instinct in-stinct to live is the most dynamic asset he has. This is why the effort made to help a sick child very often yields great rewards. |