In the hope that this clears up any confusion re Dr Phoon and the bolt cutters

Dear Beagle Editor, This is just to clear up the confusion which has arisen due to the news about Dr.Phoon apparently trying to use a bolt cutter bought from the hardware store during surgery.

I feel this should be explained as it is obviously being used to portray "unhygienic " practice which is simply not true.The facts are as follows.

The patient had a severe ankle fracture and because of the swelling, he ended up having a frame across his ankle to hold it together until we could operate. This is standard procedure and was performed by one of the locum surgeons. Part of the frame is held together by a thick metal pin passing through the heel bone with both ends projecting out of the skin. To remove this pin,we have to cut off one of the protruding ends outside the skin and pull the other end out so as not to have exposed and contaminated metal passing through the bone. So the bolt cutter is for use OUTSIDE the skin. It is not in contact with the main wound at all. The only part it may come in contact with is the skin where the pin is going into the bone. Moreover, Dr. Phoon did not duck down to the hardware store in the middle of an operation. He tried to get a replacement from other hospitals because the operation was not an emergency but a planned one. Obviously he could not leave it for too long and hence he obtained the bolt cutter. Is there a risk of infection? Unlikely,as this was to remove the part of the pin sticking out of the skin before the leg could be cleaned and draped for surgery and NOT for use in the actual surgery. Hope this clears up the confusion. Dr Krishnankutty Nair Rajesh Bega

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