Inside UCSF's Orthopedic Trauma Institute, Dr. Rich Gosselin is sharing advanced surgical techniques with doctors from around the developing world, but this is no ivory tower lecture. Gosselin has honed field techniques in hot spots around the world, most recently at a refugee clinic just outside the border of Syria.
"I was, I guess, unfortunate enough to be there at the time there was this big battle you may have heard of for a city called Qusair," said Gosselin.
He says several patients were diagnosed by the Red Cross with lesions consistent with exposure to the chemical weapon sarin gas. While those reports drew international attention, the overwhelming challenge from a surgeon's point of view is trauma. Severe injuries from car accidents and worse are often left untreated until the patients reached the border.
"Resetting the bones that have healed crooked or that have not healed and chronic wounds that have been draining for weeks," said Gosselin.
During the seminar at San Francisco General Hospital, Gosselin and other surgeons teach techniques like free flaps, drawing skin from around the wound in order to close it, along with other methods that don't require surgical hardware.
"So what we're accustomed of using here for many of those injuries, like nails, plates, screws and so forth, are not available over there," said Gosselin.
Engineers at the institute have also adapted devices to give surgeons inexpensive alternatives in the field. For example, a syringe that can help drain infected areas and then apply antibiotics or sterilization bags that allow commercial drills to be used in bone repair.
"We're here to share ideas to try to get people thinking about what can be constructed locally in many of these environments that don't have access to high tech things," said UCSF Dr. Richard Coughlin.
Many of the students come from Sub-Saharan Africa and southern Asia, bringing ideas they've developed regionally. Those are shared along with the UCSF curriculum. The goal is to empower doctors to reteach what they've learned here to colleagues at home.
"In fact, they get a number of great procedures and techniques that they can take back and use right away as soon as they get back to their hospitals," said Coughlin.
One example is a doctor from Tanzania who held a seminar of his own after returning to Africa. It drew more than 100 doctors from the area who likely have never been able to travel overseas.
Written and produced by Tim Didion