2.17.2014
Greetings from Vietnam!
I have now been working with the brilliant dermatology
faculty and residents of Ho Chi Minh City College of Pharmacy and Medicine for one
week and I must say this has been one of the most memorable and impressionable
learning experiences I have encountered throughout residency.
A little background for you….. For years, the country of
Vietnam has lacked the appropriate means for effective, early intervention of
disfiguring vascular anomalies. The
standard of care has historically included the use of radioactive phosphorus
for infantile hemangiomas and even in some cases vascular malformations. This
treatment is not only painful for the children but leaves behind disfiguring,
stigmatizing, and painful scars, many of which are located in the facial
region. Five years ago, Dr. Thanh Nga Tran and Thuy Phoung (both natives of
Vietnman) decided they would put a stop to this treatment once and for all.
Both having trained in the Harvard Dermatology and Dermatolopathology programs
respectively, they determined to join forces with Dr. Rox Anderson (expert in
the laser and medical treatment of vascular anomalies) and Dr. Martin Mihm
(expert in vascular anomalies and dermatopathology).
Dr. Tran spent one month at the Ho Chi Minh College of
Pharmacy and Medicine as a senior dermatology resident and during this time
made contact with two of the most honest, hard-working, and caring dermatologists
any of us has met, Drs. Hoang Minh and Bo Famy. Together, this remarkable team
of physicians established the first vascular anomalies clinic of Vietnam five
years ago this month.
The clinic began with 1 laser, the pulsed dye laser, an
operating room with anesthesiologist, a team of eager residents, and of course
a line of patients. Through much fund-raising and generous donations from
various laser companies, the OR is now replete with the top four lasers needed
for the treatment of various vascular anomalies. This accomplishment in only
five years time is truly remarkable.
Now for the present…..Upon arriving in Vietnam at 1:30 AM,
the hospitality of this program was evident immediately. Second year resident-
Anh Dao was there with her little brother holding a sign with my name as soon
as I exited the airport in Ho Chi Minh City. I must say this was so comforting
having never been to this country and not speaking the language.
Our first day in clinic was truly an eye-opening experience.
It began with the evaluation of several children with disfiguring scars from
the treatment with radioactive phosphorus. In the year previously, Dr. Anderson
was able to bring a new device that he invented which harvests a “blister
graft” from the thigh, which can then be grafted to the site of a scar (after
superficial epidermal ablation). He
trained Drs. Famy and Minh on the utility of this device and they were able to
treat several of the children in the last year. The results are truly
remarkable! Nearly normal pigmentation
and texture resulted. This is life changing for these children whose scars are
located in the facial region. Additionally, this is ground breaking in the
treatment of radiation injury. Thankfully, we were able to treat several
additional children during our time this year.
Additionally, we evaluated and treated numerous children
with hemangiomas, capillary malformations, lymphatic malformations, and venous
malformations.
It was amazing to observe how brave these children are here.
They literally walk into a room of 15-20 physicians and sit in the middle
quietly while we discuss the treatment plan.
A great deal of our time was also spent teaching the
residents and attendings how to develop treatment plans, including the use of
medical management, such as topical timolol and oral propranolol, in
combination with laser treatment. At the
end of the week several members of our group spoke at the annual CME conference
held at the University. Much to our surprise, this year’s attendance hit a
record high of over 500 doctors from across Vietnam!
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