Početna Intervju Šta je rekla doktorica Violeta prije smrti

Šta je rekla doktorica Violeta prije smrti

Detaljno je objasnila sve…

Nakon prvog talasa pandemije, Srbija je polako ublažava mjere – otvarali su se teretane, frizerski i kozmetički saloni. Kako će se COVID-19 reflektovati na estetsku plastičnu hirurgiju nakon pandemije Ispričala je Violeta Skorobać Ašanin, koja je prošlog vikenda izvršila samoubistvo.

Ona je inače bila specijalista plastične, rekonstruktivne i estetske hirurgije, predsjednicom Udruženja estetskih plastičnih hirurga Srbije SRBSAPS, i do skora predsedavajućom Evropskim komitetom za bezbednost pacijenata EASAPS, a evo šta je u aprilu ispričala za portal “Srbija danas“.

Nakon prvog talasa pandemije, Srbija je polako ublažava mjere – otvarali su se teretane, frizerski i kozmetički saloni. Kako će se COVID-19 reflektovati na estetsku plastičnu hirurgiju nakon pandemije Ispričala je Violeta Skorobać Ašanin, koja je prošlog vikenda izvršila samoubistvo.

Ona je inače bila specijalista plastične, rekonstruktivne i estetske hirurgije, predsjednicom Udruženja estetskih plastičnih hirurga Srbije SRBSAPS, i do skora predsedavajućom Evropskim komitetom za bezbednost pacijenata EASAPS, a evo šta je u aprilu ispričala za portal “Srbija danas“.

Kriza je skoro svuda ista, pa se postavlja pitanje kako prevazići pandemiju i šta poslije nje da li će estetska plastična hirurgija biti ista nakon pandemije COVID – 19?

Nova pandemija korone – virusne bolesti koja se brzo širi, uzrokovana teškim akutnim respiratornim sindromom, dovela je do uvođenja do sada neviđenih mjera za njeno suzbijanje i prevazilaženje. Dosadašnja nastojanja brojnih udruženja, među kojima i Udruženja estetskih plastičnih hirurga Srbije – SRBSAPS, je razvoj koncepta bezbjednosti pacijenata – ‘Patient safety’, posebno danas dobija na značaju.

Pružanja kvalitetne usluge pacijentima, izbor prave procedure, izbor sertifikovanog i edukovanog estetskog plastičnog hirurga, kao i pažljv odabir pacijenta za određenu hiruršku proceduru, su osnovni postulati koncepta ‘Sigurnosti pacijanata’. Ukazivanje na značaj ovog koncepta radi zaštite zdravlja populacije dobilo je svoj epilog sa pojavom pandemije, koja je zaustavila planetu za sve elektivne hirurgije, uključujući i plastičnu.

Nakon prvog talasa pandemije, Srbija je polako ublažava mjere – otvarali su se teretane, frizerski i kozmetički saloni. Kako će se COVID-19 reflektovati na estetsku plastičnu hirurgiju nakon pandemije Ispričala je Violeta Skorobać Ašanin, koja je prošlog vikenda izvršila samoubistvo.

Ona je inače bila specijalista plastične, rekonstruktivne i estetske hirurgije, predsjednicom Udruženja estetskih plastičnih hirurga Srbije SRBSAPS, i do skora predsedavajućom Evropskim komitetom za bezbednost pacijenata EASAPS, a evo šta je u aprilu ispričala za portal “Srbija danas“.

Kriza je skoro svuda ista, pa se postavlja pitanje kako prevazići pandemiju i šta poslije nje da li će estetska plastična hirurgija biti ista nakon pandemije COVID – 19?

Nova pandemija korone – virusne bolesti koja se brzo širi, uzrokovana teškim akutnim respiratornim sindromom, dovela je do uvođenja do sada neviđenih mjera za njeno suzbijanje i prevazilaženje. Dosadašnja nastojanja brojnih udruženja, među kojima i Udruženja estetskih plastičnih hirurga Srbije – SRBSAPS, je razvoj koncepta bezbjednosti pacijenata – ‘Patient safety’, posebno danas dobija na značaju.

Pružanja kvalitetne usluge pacijentima, izbor prave procedure, izbor sertifikovanog i edukovanog estetskog plastičnog hirurga, kao i pažljv odabir pacijenta za određenu hiruršku proceduru, su osnovni postulati koncepta ‘Sigurnosti pacijanata’. Ukazivanje na značaj ovog koncepta radi zaštite zdravlja populacije dobilo je svoj epilog sa pojavom pandemije, koja je zaustavila planetu za sve elektivne hirurgije, uključujući i plastičnu.

Očigledno je da su eksperti u oblasti plastične hirurgije išli u korak sa vremenom kada je u pitanju bezbjednost pacijenata, šta činite u toku pandemije COVID-19?

U svjetlu svih ovih osnovnih pretpostavki i nesigurnosti, neophodno je dodatno osmisliti i primjeniti klinički relevantne algoritme zasnovane na bezbjednosti, kako nas ljekara, tako i pacijenata, usmjerenih na donošenje odluka i pravljenje novih protokola za odgovarajuće hirurške i nehirurške procedure. Očuvanje kvalifikovane radne snage u zdravstvu je glavni prioritet bilo koje zajednice pa i zdravstvenog sistema jednog društva. Imajući u vidu iskustva zdrastvenih sistema u Aziji i Evropi koja potvrđuju značaj lične zaštitne opreme, ne samo za smanjivanja rizika od izloženosti infekciji zdravstvenih radnika već i za povećan nivo sigurnosti pacijenta, neophodna je njena implementacija.

U skladu sa tim ISAPS, kao najveće međunarodno udruženje estetskih plastičnih hirurga, organizovao je 7. aprila online seminar – Webinar, na kome su diskutovala tri predsjednika: Dirk Richter, sadašnji predsejdnik, Renato Saltz, bivši predsjednik,, Nasim Cerkes, budući predsjednik, o budućnosti hirurških i nehirurških estetskih procedura nakon pandemije.

Činjenice govore da bilo koje hirurške procedure slabe imunitet pacijenta, da li je povećan rizik operacija u toku i nakon pandemije?

Tačno je da bilo koja hirurška procedura utiče na smanjenje imuniteta. Potrebno je da preoperativno imunitet bude dobar da bi se pacijent brzo oporavio i zacjelio nakon operativnog zahvata. Na primjer, samo saznanje da virus Covid-19 povlači sa sobom gvožđe iz hemoglobina i stavlja ga u slobodnu cirkulaciju, otvara brojna pitanja, kao što su postoperativna anemija sa jedne strane, a sa druge strane slobodno prisustvo gvožđa u cirkulaciji povećava nivo njegovog toksičnog dejstva na unutrašnje organe.

Imunitet pacijenta će svakako biti prioritet u trijaži pacijenata i odabiru hirurške intervencije. Kako su trenutno u čitavom svijetu plastična estetska hirurgija i invazivne nehirurške metode zaustavljene, postepeno uvođenje i pokretanje ove grane medicine biće neminovno.

Kakvi će biti postupci i vremenske odrednice u obnavljanju funkcionisanja rada zdravstvenih ustanova i privatne prakse u oblasti estetske plastične hirurgiju u novim okolnostim koje je nametnula pandemija COVID-19?

Prvi korak je testiranje osoblja pri povratku na posao, a nakon toga i pacijenata koji se pripremaju za ovu vrstu operacija. Preoperativno testiranje, kao i ubacivanje podatka o Covid-19 u informativne pristanke, biće početna stanica za uvod ovih pacijenta u procedure. Po mišljenju eksperta za septorinoplastiku dr Nazim Cerkesa, hirurgija koja je vezana za disajne puteve, poput operacije nosa i sinusa, spadaće u red visoko rizičnih operacija. Široka dostupnost testiranja pacijenta kao i mogućnost lažno negativnih rezultata, uključiće obavezu ponovnog testiranja u određenim vremenskim intervalima. Za sada je to kod nas nakon sedam dana, dok se u pojedinim zemljama kao što je Turska preporučuje na svaka tri dana kao i neposredno pred hirurgiju brzim testovima za utvrđivanje postojanja virusa u organizmu.

Sve ovo će produžiti vremenski tok pružanja usluga u plastičnoj hirurgiji, od preoperativne pripreme, same intervencije do postoperativne brige o pacijentu. Široka dostupnost PCR testova kao njihova pristupačna cena pomogla bi da se na ovaj način brže i sigurnije pristupi hirurškim procedurama. Pitanje je kako će farmaceutska industrija odgovoriti na sve ove izazove, i na koji način će se sa finansijske strane učiniti dostupni ovi farmaceutski proizvodi.

Neophodnost aktivnog uključivanja imunologa i virusologa pomoći će da se jasnije i sigurnije definišu preoperativni protokoli, kao i mogućnosti liječenja u skladu sa negativnim ishodom.

Hoće li se uopšte raditi estetske operacije?

Mišljenje učesnika Webinara je da će biti neophodno postupno uvođenje estetskih procedura, najprije kod imunološki zdravih mlađih pacijenta, i to hirurgije grudi i tijela. Nakon toga će se uključivati operacije na licu, a na kraju endonazalna i endoskopska hirurgija. Za sada se ne zna mnogo o virusu COVID-19, ali se pretpostavlja da će biti nemoguće da on u potpunosti bude eliminisan. Očigledno je da ćemo morati da nađemo način kako da se borimo sa virusom, kako bi zaštitili pacijente i sebe. Na primjer, serološki testovi koji nam daju rezultat da je pacijent IgG pozitivan, a IgM negativan, daće nam mogućnost da takvog pacijenta operišemo.

U svim operacijama ključna je koordinacija sa anesteziološkim timom. Date su preporuke za rad anesteziološkog i hirurškog tima od proceduralnih, tehničko-tehnoloških do nošenja lične zaštitne opreme, sterilizacije, razmjene vazduha u operacionoj sali ili slično.

Ali kako obezbjediti socijalnu distancu u vašem poslu?

Ipak bih napravila razliku, socijalni odnos se treba očuvati a zadržati fizičku distancu u toku pandemije. Panelisti su postavili pitanje bliskosti pacijenta i ljekara pri konsultacijama, ili kada su u pitanju anti-ageing procedure. Jasnih preporuka nema jer je svaka zemlja donijela svoje mjere i uputstva rada ljekarske prakse u toku pandemije. Generalno, preporuka je da se preduzmu sve mjere lične zaštite, načina neposrednog pregleda pacijenata i uzimanje anamneze. Testiranje pacijenata za manje hirurške intervencije i procedure anti-ageing-a.

Nije prvi put da se nauka i medicina susreću sa izazovima i teškim vremenima i da će se naći rješenja koju će ovu zaraznu bolest staviti pod kontrolu. Ono što svi zajedno možemo uvijek učiniti za sebe je da ojačamo naš imuni sistem; više zdravog života, više kretanja i fizičkih aktivnosti, unošenja vitamina i minerala poput selena, vitamina D, E i drugih, pomoći će da se odupremo virusima i infekcijama kojih
će uvijek biti.

Iz Vaše dosadašnje hirurške prakse koja bi bila vaša poruka za prevazilaženja krize i uspostavljanje normalnog rada u oblasti estetske plastične hirurgije nakon pandemije?

Po mom mišljenju, doći će do promjena u djelu zdravstvenih procedura prije svega vezane za izbjegavanje stresa na relaciji hirurg – pacijent i uspostavljanje međusobnog povjerenja. Suštinsko povjerenje koje pacijent polaže u hirurga donošenjem odluke da pristupi određenoj intervenciji, mora biti praćeno transparentnom posvećenošću svim mjerama prevencije i zaštite zdravlja pacijenta kao i smanjenja rizika od potencijalnih komplikacija.

Neophodna je socijalna i profesionalna odgovornost radi spriječavanja brze trasmisije ovog virusa među populacijom. Definitivno će doći do mnogih promjena kako u životu pojedinca, tako i globalno u ekonomiji, medicini, nauci, politici. Sa stvaranjem socijalne distance, prepostavlja se da će se razviti i drugačiji životni stil među ljudima.

Skoro pa nema oblasti rada i društvenog života gdje pandemija COVID-19 nije izazvala ozbiljne implikacije i zaustavila rad u mnogim djelatnostima. Kako se ona odražava na vaš rad?

Implikacije su vidljive u mnogim sferama. Predviđanja su da će edukacije koje su okupljale veliki broj hirurga na jednom mestu zamijeniti telemedicina i webinari tako da je i veliko pitanje šta će biti sa kongresnim turizmom. Takođe, trenutno ne postoje predviđanja šta će u budućnosti biti sa medicinskim turizmom, imajući u vidu aktuelna zatvaranja državnih granica, finansijske probleme mnogih avio kompanija i prevoznika, kao i druge odluke država i vlada u cilju spriječavanja širenja virusa. Da vas podsjetim, posljednjih nekoliko godina došlo je do povećanja broja usluga koje smo pružali pacijentima iz inostranstva, a uz podršku Ministarstva zdravlja plan je bio da se taj broj u narednim godinama značajno uveća kao jedan od potencijala ekonomskog razvoja Srbije.

Kakva će biti situacija u budućnosti teško je sada procjeniti, ali da će doći do usporavanja razvoja medicinskog turizma ne samo kod nas već i u svijetu gotovo da je sigurno. Izazovi sa kojima se suočavamo u vrijeme globalne pandemije zahtevaju izuzetne napore da bi se izbjegao kolaps naše ljekarske prakse. Svi dijelimo istu poziciju koju nam je pandemija donijela. Poštovali smo preporuke Kriznog štaba da se u vrijeme vandrednog stanja i u uslovima pandemije obustavi elektivna hirurgija, kojoj pripada i plastična.

Ovih dana je najavljeno i popuštanje mjera za spriječavanje širenja pandemije i očekivanja, ne samo moja već i mojih kolega su da se što prije stvore uslovi za normalne aktivnosti i rad u okviru naše profesije. Mi smo kao Udruženje estetskih plastičnih hirurga Srbije – SRBSAPS, preuzeli inicijativu da se shodno situaciji uvedu novi protokoli u rad privatnih zdrastvenih ustanova i lekarske prakse, da bi se pružila maksimalna bezbjednost kako pacijentima tako i zdrastvenim radnicima u okviru naše djelatnosti.

Da li će se najavljena recesija i ekonomska kriza odraziti na pružanje zdrastvenih usluga?

Govoreći iz aspekta estetske plastične hirurgije, sva naša očekivanja su da što pre prevaziđemo trenutnu krizu, sačuvamo našu profesiju i zdravlje naših pacijenata. Put do toga je dug i neizvestan i sigurno, za sada, nemamo odgovore na mnoga pitanja. Svjedoci smo da svaki novi dan ili nedelja donosi nova pravila kojima moramo svi da se prilagođavamo. Sigurno je da će ekonomske mjere državnih organa Srbije za suzbijanje ekonomskih posljedica za vrijeme pandemije COVID-19 pomoći da se prevaziđu neka od gorućih pitanja.

Recesija i ekonomska kriza koja se sada čini daleko, jer je trenutno najvažnija borba za zdravlje svih, djeluju neizbježno, pitanje je kako će svakog od nas i u kojoj mjeri pogoditi. U svim kriznim situacijama i različitim aspektima društva i delatnosti, krucijalno je važno da se jedinstveno suočimo sa ovim izazovima i damo svoj doprinos u zajedničkom prevazilaženju nastale situacije.

I vaša poruka na kraju…

Kraj pandemije će predstavljati novi početak.

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