Dr. Antonyshin’s surgical landing. How Canadian doctors help seriously injured Ukrainians perform plastic surgery

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Mykhailo Potyshniak miraculously survived the rocket attack on his native village of Novovorontsovka in the Kherson Region, which took place on August 5, 2022. His wife and son were killed by the explosion, and Mykhailo was as if his scalp had been removed – 85-90% of his head was burned. The doctors of the Kryvyi Rih hospital, where the man was admitted after the tragedy, stabilized his condition. But the doctors were worried that the infection could spread to the brain, because it, in fact, remained open. Mykhailo was saved by a team of Canadian doctors. After medical evacuation from Ukraine to a hospital in Poland, surgeons performed plastic surgery on him for 11 hours in a row, replacing each other. A piece of muscle from the back was used to close the skull. Now the Ukrainian is gradually recovering in a Polish hospital. The team of doctors is managed by Oleg Antonyshyn, a Canadian citizen and Ukrainian by origin, a world-renowned plastic surgeon. He started operating on Ukrainians during the Revolution of Dignity in 2014. During these years, the doctors of the Canadian Surgical Mission (Саnada Ukraine Surgical Aid Program CUSAP) provided free assistance to 286 Ukrainians. Since September 2022, the main base of the Canadian mission is located in the hospital of the Polish town of Chelyadz, a special department has been set up here, which has even been called the “Canadian Wing”. At the end of last year, 44 Ukrainians were operated on there. All of them had complex facial injuries and required plastic surgery. For each of them, such an operation meant the possibility of returning to a normal life. Oleg Antonyshyn assembled a powerful team of volunteer doctors to operate on patients with severe facial injuries. It consists of real stars of the profession: many have heard, for example, about Steve McCabe, who together with the team performed the first hand transplant in the world. How did doctor Antonyshyn manage to unite the best doctors of Canada and the USA to operate on Ukrainians for free? “Ukrainian truth. Life” tells the story of an incredible volunteer initiative. Oleg Antonyshyn – a plastic surgeon with a world name Injuries, never seen before For the first time, Dr. Antonyshyn came to Ukraine, to his parents’ homeland, after the Maidan in 2014. When Yanukovych fled the country, he, together with a small group of doctors (mostly Canadians of Ukrainian origin) and Ulyana Suprun, received an invitation from the Canada-Ukraine Foundation (CUF) to visit the hospitals where the wounded Maidan activists were. During the first humanitarian trip, the group visited about 20 hospitals and clinics and even managed to reach Donetsk. Doctors were returning home on the last plane from Donetsk airport. Then, on the way to Toronto, Oleg Antonyshyn carefully considered the plan to help Ukrainian patients. “It was immediately clear that it would be very expensive to transport Ukrainians to Canada for treatment. Therefore, the best solution is to bring doctors from Canada to Ukraine,” he explains. This is the second mission of Canadian doctors since the beginning of a large-scale war and the ninth since the Revolution of Dignity. Then, in 2014, Canadian specialists were accepted by the Kyiv Military Hospital. “In the military hospital, we could perform complex operations because there are high-class practicing surgeons and enough specialists of other profiles,” explains Dr. Antonyshyn. Since then, a team of Canadian surgeons has been working closely with the capital’s doctors. From the beginning of the mission, the team aimed to simultaneously treat patients and train Ukrainian surgeons. Ukrainian doctors are not just present at operations, but also accompany the postoperative recovery of patients. The Canadian surgical mission also cooperated with hospitals in Odesa and Lviv before the full-scale invasion. They were even going to build a training base there – but the war changed the team’s plans. Already on the second day after the start of the full-scale invasion in 2022, Dr. Antonyshyn gave a comment to the Canadian TV channel CBC and said that he was going to Ukraine. “The day after the appearance on television, we received more than 120 applications from doctors of various specializations from all over North America,” says mission coordinator Yulia Malaniy. The management of Sunnybrook Health Center, where Dr. Antonyshyn has been working for more than 30 years, also agreed to let their doctors go on a mission. The main question was the place – where to set up the surgical base? It is dangerous to take international doctors to Kyiv, so it was decided to create a temporary base in Poland. Only patients with complex craniofacial injuries, such as Mykhailo Potyshniak, are admitted to the Canadians for surgery. Ukrainian doctors do not always have enough equipment, specific instruments to operate on the face. Nevertheless, Ukrainian surgeons play a significant role. It is they who collect a complete history, describe in detail how and when the injury was received, translate all this information into English and pass it on to Canadian doctors. Such cooperation helps to properly prepare for each operation: bring the necessary equipment, materials, print artificial implants and calculate the risks that surgeons may face during the operation. Ukrainian doctors are not only present at operations, but also accompany the postoperative recovery of patients. Each operation lasts from 6 to 15 hours in a row. Many of them are performed in two or three stages until the plastic surgeons achieve the desired result. “Since 2014, we have seen many wounded soldiers, they had at least some protection, in the form of helmets and body armor. Now we have wounded civilians with injuries that we have not seen before. They are not prepared either physically or mentally for such tests. By nature injuries, we understand how much the intensity of hostilities has increased,” Antonyshyn explains. Often, in order to reconstruct the face, plastic surgeons have to transfer bones to patients from other parts of the body. Or use artificial implants pre-printed on a 3-D printer. “One of our patients is a young man who was missing half of his nose and the skin above his jaw. We took cartilage from our “cartilage bank” and reconstructed the structure of his nose, then covered it with a piece of his own skin. At first it looks very scary, but during “The wounds heal in 4-5 weeks. Then the second stage begins, which will allow the complete reconstruction of the structure of the nose,” says Dr. Antonyshyn. He personally performed the first operation on this young man, and Kyiv surgeon Oleksandr Lompas was also present at it. Understanding the further plan of treatment, Lompas already has to perform a second operation on the patient. Yulia Malaniy, the mission coordinator, says that every patient is prepared psychologically. The treatment plan is explained in detail, “before” and “after” photos of other people with similar diagnoses are shown. “The outcome of the operation and how quickly the new bones or skin will take root depends very much on psychological readiness,” Yulia explains. A team of doctors performs plastic surgery. The future of Ukrainian plastic surgery. the first time we came to Ukraine and the main military hospital, maxillofacial surgeons worked in one building, and neurosurgeons in another – and they did not cross paths. As practice shows, the involvement of other specialists makes the operation more qualitative,” says Antonyshyn. He considers Ukrainian surgeons to be high-level professionals who currently have the most experience in complex trauma operations. According to the doctor, this surgical field is developing rapidly thanks to technologies that make it possible to get better results at the expense of accuracy. At the same time, key approaches in Ukrainian craniofacial surgery must change. “Ukrainian surgeons are now at the forefront. And in a few years, Ukraine may have its own plastic school,” says Antonyshyn. 11 Ukrainian doctors participated in the last Canadian mission. “I am proud of such Ukrainian doctors as Ihor Fedirko, who completely independently performs the reconstruction of the worst defects. We brought him equipment, he practices in the Kyiv military hospital, and I see how his professionalism is growing,” says Dr. Antonyshyn. During 8 years of cooperation, many Ukrainian surgeons have already become not just his students, but also friends. During all the years of operation of the mission, almost 2 million Canadian dollars worth of equipment was brought to Ukraine. 286 patients were operated on. Each plastic surgery that Canadians do on a volunteer basis would cost 250,000 Canadian dollars. Only one screw can cost from 32 to 200 dollars, an implant from 10-17 thousand dollars. The operating expenses of the medical team for medicines and equipment are paid by the Canadian fund СUF. “We are very lucky that we have Dr. Antonyshyn, who has gathered all the necessary knowledge not only to provide the help Ukrainians need, but also to inspire other doctors to do the same,” says the head of the foundation Viktor Hetmanchuk. Anastasia Ringis, specially for UP.Zhyttya Read also: “On February 24, we did not stop any operation.” How the largest children’s hospital saves lives before the invasion begins

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