How Vitaliy’s treatment is progressing:

10.06.2015: Vitaliy prepares to return home to Kherson



08.06.2015: First stage of treatment for “Cyborg” Vitaliy



Wounded:

Vitaliy, 37, a soldier with the 93rd Mobile Brigade, wounded in Donetsk Airport.

Wound:

Consequences of shrapnel wounds to both tibias and his right foot.

Right leg: a tibia defect (loss) of 8 cm of the bottom third of the bone, a defect of the talus, navicular bone and the metatarsal bones of the right foot, fixed with a rod-type apparatus, a right fibula defect of about 12 cm, fixed with rod a type apparatus.

Left leg: tangential defect of the tibia in the middle third of about 8 cm, with varus (knock-knee) and rotational deformity.



Traditional treatment methods offer no solutions for effective treatment of such defects, this injury threatens disability through shortening of the limbs, or one to three year-long extraction by Ilizarov, that also is seldom effective in such cases.



More information about the wounded:

Vitaliy – a fighter with the now-legendary 93rd Brigade. Together with his brothers in arms he was transferred to the Brigade from the Donbas Battalion.



On January 17 Vitaliy’s unit was involved in the rescue of 126 surrounded soldiers. They made a corridor and heroically protected it under a barrage of mortar fire.

While on a mission a mine exploded near Vitaliy causing him multiple injuries – he lost a lot of blood, and his body was pierced by shrapnel. Right Sector personnel provided first aid to the fighter, and then the unconscious Vitaliy was transported to Selidovo. A significant part of his treatment was carried out in Dnipropetrovsk Mechnikov Hospital. Here, due to purulent necrotic process, the hero underwent six surgeries, under constant threat of single or double amputation.

Later he was transferred to Kyiv Central Military Hospital.

Now Vitaliy faces permanent disability due to limb-shortening of up to 10 cm, along with dysfunction of his legs, he will likely have a very serious problem with his center of gravity which will shift and may result in severe spine disease. His spine is already an Achilles heel for Vitaliy as he suffers from a herniated inter-vertebral disc. To save this hero from suffering these problems, the volunteers of The People’s Project advised the soldier to apply to the Bioengineering Rehabilitation for Wounded project. Doctors have promised to do everything possible through the use of cellular technology to help Vitaliy regain his health.

The soldier grew up in the Bratsk Yakut region in Siberia, where he lived with his family until 1992. It was there he developed an interest in the winter sport of biathlon, taking part in regional competitions.

After leaving Russia, Vitaliy’s family settled in his mother’s homeland – in Tsyurupinsk region of Kherson. In peacetime, Vitaliy was a farmer, growing vegetables and fruit while having a sideline as a car mechanic. He loves what he does, and also harbors a dream of opening his own smithy.

At home Vitaliy is much missed by his family: his pregnant wife, 13-year-old daughter, and son, 7.

Required treatment:

Reconstructive-restorative treatment of both tibia using stem cell technology. Treatment will consist of three phases, each of which include three surgeries.

List of procedures included in the treatment:

Diagnostics and examination: 4,055 UAH

Stage 1 treatment:

• 1 surgery on his shin (wound revision, granulating wound plastic surgery, apparatus fixation to the tibias, collection of fibula fragments and bone marrow): 39,990 UAH

• 2 operations on both shins (shin-foot apparatus, production of individual carrier, preparation of cellular material, biotechnological spending – 200 million cells, medical provision, hospitalization and examination expenses): 257,586 UAH

2 stage treatment:

• Treatment to one leg (implantation of cell-tissue material in a block form to the right leg, osteosynthesis of diaphyseal tibia bone with 1 plate): 41,240 UAH

• Treatment of the second leg (implantation of cell-tissue material as a block in the left leg, osteosynthesis of diaphyseal tibia bone with 1 plate, medical support, hospital examination): 60,337 UAH

Budget update

In March treatment of the fractures to both legs was completed. Now Vitaliy is actively developing the muscle. But when calculating the cost, the clinic did not consider the costs of the removal of external fixation devices from both legs. There was a need to cover these costs to the amount of: 25,276 UAH.

All surgeries Vitaliy underwent in iLaya were successful. New bone in both shins has already formed and he can gradually apply more weight on both legs.

However, due to the significant size of bone defect, there is still an nonunion place in his left shin bone. This defect requires external bone fixation with an Ilizarov apparatus and physiotherapy. Additional treatment costs amounted: to 98,701 UAH.

In 2015-2016, doctors conducted the main stages of the treatment of defects in Vitaliy’s shinbones. Now the restoration of bones is ongoing, but because of the extraordinary complexity of the injury, a number of complications for doctors to address arose in the course of treatment.

– Firstly, due to injury, the soldier lost most of the essential vessels in his legs, thus the recovery of bones was slow. Control X-ray examination showed an unhealed bone area near the right ankle joint. The doctors decided to revise the place of injury and appoint an additional treatment after the bone examination. The cost of an additional surgery amounted to 90,596 UAH.

– Before that, in the process of treatment, there was a need for an additional surgery on the left foot to restore the leg functions. During this operation, in January 2017,

doctors performed tenolysis, mounted external fixation device to put the foot in the physiological position, and also removed the apparatus from the right leg. Expenses for these additional procedures amounted to 94,499 UAH. The cost of this stage also includes the cost of removing the external fixation device from the left foot. After that, Vitaliy was able to start putting pressure on his right foot and walk with walkers. After the device from the left foot will be removed, Vitaliy will start to exercise the left leg as well.

– Another problem was that due to insufficient blood supply to the places of injury, the healing process was too slow. Therefore, cells were injected additionally to strengthen Vitaly’s bones. Costs for this additional stage amounted to 21,764 UAH.

– Later, in the process of recovery, due to insufficient blood supply to the injury site on the right leg, it was necessary to mount the apparatus of external bone fixation to accelerate the process of healing. Fortunately, the left leg healing is much faster. The costs for the additional stage amounted to UAH 46,353.

– Due to extremely difficult injuries, prolonged treatment and, as a result, depletion of the Vitaliy’s organism, regeneration processes occur more slowly than it would be desirable. A lot of work has already been done and there are many positive changes. But during the last X-ray examination at the beginning of 2018, the area of the left tibia that was not completely restored and needs an additional application of bone chips with cells was discovered. The operation was conducted in February. Expenditures for the extra stage amounted to UAH 123,660.

– At the moment the main task is to make the legs strong enough to carry the weight of the body. Due to the poor blood supply to the feet as a result of the injury, the bones regenerate slowly and remain thin and fragile. In order to overcome these problems, in early March 2018 additional surgeries were performed. Namely plastic surgery to treat the scar tissue, another plastic surgery of the wound with a rotated skin flap on the left leg, osteotomy of the right tibia and fibula, and the installation of the shin-foot repositioning apparatus to correctly align the bones. The costs for these operations amounted to 121,616 UAH. Also, for the future, three additional operations are scheduled. The cost of which will be UAH 307,653. Namely: the dismantling of external fixation apparatus from both legs in July 2018, surgery on the right leg (plastic surgery of the scar, ulcerative defect with a rotated skin flap, the plastic surgery of the wounds with a split skin flap, the formation of recipient bed, non-focal interstitial osteosynthesis) in August 2018 and surgery on the right leg (disassembly of the apparatus, formation of the recipient bed, transplantation of the bone chips) in October 2018.

Updated special price of treatment: 1,333,326 UAH