For Karter, a 4-year-old from Hastings, Neb., a ride on his dad’s lawn mower is nothing out of the ordinary. However, on April 13, 2022, this routine father-son task resulted in an accidental injury that required transport to Children’s via helicopter.
Marissa Stec, Karter’s mom, recalls the terrifying day her son inadvertently got off on the wrong side of the mower and critically injured his foot. “I was scared he was going to lose his foot and was unsure how we were going to manage everything if that was the case,” she says.
When Karter arrived in Children’s Emergency Department, a collaborative crew from Children’s Orthopedic and Plastic and Reconstructive Surgery teams worked together to ensure the best outcome.
Pediatric orthopedic surgeon Brian Hasley, M.D., performed the first operation to stabilize Karter’s fracture and improve the healing potential of his remaining healthy tissue to maximize function of his foot.
From there, plastic and reconstructive surgeon James Vargo, M.D., took over the reconstruction process.
“You never know what to expect walking into cases like this; you need to be prepared for any type of reconstruction,” Dr. Vargo says. “We communicate closely with our orthopedic surgeons. Usually, it involves a phone call and some photos, and then we work together in the operating room to come up with a plan that will optimize outcomes for our patients.”
Since Karter’s injury resulted in multiple severe lacerations on the bottom of his foot and significant tissue loss, along with open fractures, he was susceptible to infection. So Dr. Vargo’s team performed multiple wound washouts and tissue manipulations on his foot.
According to Dr. Vargo, traditional reconstruction would have required a complex flap reconstruction, but the team elected to use an innovative new material on his wound—NovoSorb® BTM (Biologic Temporizing Membrane)—to minimize infection and help Karter’s body heal. Karter was the first patient at Children’s to benefit from this new synthetic product, which enabled him to heal faster with minimal postoperative difficulties.
After 17 surgeries, a 36-night stay in the hospital and ongoing rehabilitation efforts, Karter is back to energetic 4-year-old activities and doing everything he loves—especially fishing. Karter’s incredible resilience has impressed his mom, Marissa. “Nothing can slow this boy down; he surprises us daily,” she says. Marissa, who was able to stay at the Carolyn Scott Rainbow House while Karter was receiving care at Children’s, is thankful for the team effort between multiple services.
“We interacted with almost every department at Children’s—from the Emergency Department when we first arrived, to the surgical staff, security guards, nurses and aids on the Med/Surg floor and even the kitchen and housekeeping staff,” Marissa says. “It felt like we were taken care of, especially being so far from home.”
Although more operations may be needed as his foot continues to grow, Karter has been making strides in physical and occupational therapy, and was recently fitted for a compression garment to help minimize the thickening of his scars and reduce swelling.
From their home in Hastings, Karter’s parents continue to communicate with Dr. Vargo and Dr. Hasley via Children’s Connect—a secure online portal that gives parents and guardians convenient access to their child’s health care information and team. Karter also routinely receives wound care from Debra Reilly, M.D., a plastic and reconstructive surgeon at Children’s.
According to Marissa, Karter hasn’t had any major setbacks in his healing process thanks to the swift decisions of his doctors.
“Everyone worked well together and treated us like family,” Marissa says. “They even made Karter laugh despite how scared he was. Since we were there for 36 days, everyone got to know Karter, and he grew to like everyone. We had a great experience with Children’s.”
