ANAESTHESIOLOGY AND INTENSIVE CARE

16 Population Liver Transplant Unit Robotic Surgical Suite No in million No pmp No pmp Malaysia 26.64 1 100 Sector Public - 1 100 Private - State Johor 3.17 Kedah Perlis 2.11 Kelantan 1.53 Melaka 0.73 Negeri Sembilan 0.96 Pahang 1.45 Perak 2.28 Terengganu 1.04 Pulau Pinang 1.49 Sabah 3 Sarawak 2.36 Selangor W.P. Kuala Lumpur 6.43 1 100 Table 2: Available Medical Devices in General Surgery Population Automated breast Tissue Core biopsy Gun Vacuum Assisted breast biopsy Gun AbbI System Gamma Probe For Sentinel Node And Parathyroid Surgery No in million No pmp No pmp No pmp No pmp Malaysia 26.64 31 100 1 4 100 1 100 Sector Public - 24 80 2 50 Private - 7 23 2 50 1 100 State Johor 3.17 1 3 Kedah Perlis 2.11 3 10 1 1 25 Kelantan 1.53 4 13 3 Melaka 0.73 2 6 3 N. Sembilan 0.96 Pahang 1.45 2 6 1 1 25 1 Perak 2.28 3 10 1 Terengganu 1.04 Pulau Pinang 1.49 3 10 2 1 25 1 1 100 1 Sabah 3 1 3 Sarawak 2.36 2 6 1 Selangor W.P. Kuala Lumpur 6.43 10 33 2 1 25 17 Population Operating Table With Yellow-Fin boots And jacknife Positioning Capability Harmonic Scalpel Argon Plasma Coagulation System Ultrasonic Dissector and Aspirator CUSA No in million No pmp No pmp No pmp No pmp Malaysia 26.64 123 100 5 45 100 2 40 100 2 33 100 1 Sector Public - 51 41 23 51 24 60 11 33 Private - 72 59 22 49 16 40 22 67 State Johor 3.17 18 15 6 2 4 1 2 5 1 2 6 1 Kedah Perlis 2.11 5 4 2 5 11 2 5 12 2 Kelantan 1.53 4 3 3 3 7 2 3 8 2 Melaka 0.73 6 5 8 1 2 1 6 18 8 Negeri Sembilan 0.96 7 6 7 1 2 1 Pahang 1.45 3 2 2 2 4 1 6 15 4 4 12 3 Perak 2.28 18 15 8 5 11 2 3 8 1 3 9 1 Terengganu 1.04 1 1 1 Pulau Pinang 1.49 20 16 13 10 22 7 5 12 3 3 9 2 Sabah 3 12 10 4 1 2 1 3 1 3 Sarawak 2.36 11 9 5 3 7 1 2 5 1 4 12 2 Selangor W.P. Kuala Lumpur 6.43 18 15 3 12 27 2 13 32 2 10 31 2 Population Transrectal Ultrasound Anorectal Manometer Pudendal Nerve Latency Test Equipment Haemorrhoid Artery Ligation HAL Doppler Equipment No in million No pmp No pmp No pmp No pmp Malaysia 26.64 4 100 1 100 3 100 Sector Public - 2 50 2 67 Private - 2 50 1 100 1 33 State Johor 3.17 Kedah Perlis 2.11 1 25 1 33 Kelantan 1.53 1 25 1 Melaka 0.73 N. Sembilan 0.96 Pahang 1.45 Perak 2.28 1 33 Terengganu 1.04 Pulau Pinang 1.49 1 25 1 Sabah 3 Sarawak 2.36 1 25 1 100 Selangor W.P. Kuala Lumpur 6.43 1 33 18 Population Radiofrequency Ablation Unit Liver Dialysis Unit MARS Endovenous Laser Unit Craniotome No in million No pmp No pmp No pmp No pmp Malaysia 26.64 3 100 4 100 74 100 3 Sector Public - 50 68 Private - 3 100 4 100 24 32 State Johor 3.17 10 14 3 Kedah Perlis 2.11 6 8 3 Kelantan 1.53 1 1 1 Melaka 0.73 3 4 4 N. Sembilan 0.96 2 3 2 Pahang 1.45 4 5 3 Perak 2.28 7 10 3 Terengganu 1.04 Pulau Pinang 1.49 3 100 2 1 25 1 6 8 4 Sabah 3 4 5 1 Sarawak 2.36 12 16 5 Selangor W.P. Kuala Lumpur 6.43 3 75 19 26 3 Population Paediatric Upper Gastrointestinal Diagnostic And Therapeutic Endoscope Set Paediatric Lower Gastrointestinal Diagnostic And Therapeutic Endoscope Set Cystoscopy Set For Urology And Complex Intersex Surgery Paediatric Thoracoscopy And Abdominal Laparoscopy Set For Minimally Invasive Laparoscopic Surgery No in million No pmp No pmp No pmp No pmp Malaysia 26.64 14 100 1 12 100 15 100 1 13 100 Sector Public - 10 71 8 67 8 53 3 21 Private - 4 29 4 33 7 47 10 86 State Johor 3.17 2 14 1 2 17 1 1 7 Kedah Perlis 2.11 2 14 1 1 8 1 7 1 7 Kelantan 1.53 2 14 1 2 17 1 2 13 1 Melaka 0.73 1 7 1 1 8 1 1 7 1 1 7 1 N. Sembilan 0.96 1 7 1 1 8 1 2 13 2 Pahang 1.45 Perak 2.28 2 13 1 Terengganu 1.04 Pulau Pinang 1.49 1 7 1 1 8 1 2 13 1 10 78 7 Sabah 3 Sarawak 2.36 1 7 Selangor W.P. Kuala Lumpur 6.43 5 36 1 4 34 1 3 20 1 7 19 Population Vacuum Assisted Closure System VACS Dermatome Robotic Surgery System No in million No pmp No pmp No pmp Malaysia 26.64 22 100 1 51 100 2 2 100 Sector Public - 11 50 34 67 2 100 Private - 11 50 17 33 State Johor 3.17 1 5 3 6 1 Kedah Perlis 2.11 8 15 4 Kelantan 1.53 4 18 3 4 8 3 Melaka 0.73 1 5 1 1 2 1 Negeri Sembilan 0.96 1 2 1 Pahang 1.45 2 4 1 Perak 2.28 1 5 5 10 2 Terengganu 1.04 2 4 2 Pulau Pinang 1.49 1 5 1 6 12 4 Sabah 3 1 5 2 4 1 Sarawak 2.36 10 45 4 4 8 2 1 50 Selangor W.P. Kuala Lumpur 6.43 3 14 13 25 2 1 50 21

CHAPTER 6 ORTHOPAEDIC AND TRAUMATOLOGY

FACILITIES AND DEVICES Edited by: Dr. Kamariah Nor MD 1 ., Dr. Mohammad Anuar H.A 2 ., Dr. Ng YO 3 , Dato’ Dr. Ramanathan R 4 , Dr. Lee JK 5 and Dr. Mahathar AW. 1 . 1 Hospital Kuala Lumpur, 2 Hospital Raja Perempuan Zainab II, 3 Hospital Ampang, 4 Hospital Ipoh, 5 Pusat Perubatan Pantai Bangsar . REPORT External ixation is the commonest mode of treatment for open fractures. Generally all hospitals with orthopedic services will have at least one external ixator set. So, generally in Malaysia there are 333 sets of external ixators, which equate roughly to 13 sets per million population. However, in Sabah, there are only 15 sets of external ixators that are generally inadequate for the 3 million population. The distribution of external ixators is balanced between the public and private sector. However in the public sector, the distributions were high in urban areas and Wilayah Persekutuan. Overall, there is some mal-distribution of external ixators, with higher concentration in Penang 22 PMP but low concentration in Sabah. As for Ilizarov set, there are higher numbers in Sarawak 5PMP as compared to other states 1-2 PMP. The panel recommends that each hospital which provides orthopaedic and trauma services should have at least one set of external ixators each for upper limb, lower limb and mini set. Currently there are only 116 sets of upper limb external ixators 4 set PMP, which is not enough to deal with the increasing number of upper limb injuries. The Panel also suggests a more proper deinition and clariication of external ixator sets. The speciication can be varies from different companies with different capacities. In addition, data on trained personnel available to operate the devices in that particular hospital may be useful. This will indicate whether the devices are being used optimally or if they can be mobilized to other hospitals if trained personnel are not available or have been transferred. Table 1: Available Therapeutic and Diagnostic Facilities in Orthopedic Traumatology No Data To Date