A body modifier's follow-up operation on a customer's hand would have encouraged the spread of infection, an expert has told a NSW court.
Brendan Leigh Russell, 40, has pleaded not guilty to the woman's manslaughter after inserting a plastic snowflake in her hand in his parlour in a Central Coast shopping centre in March 2017.
The local woman died on April 12 – two days after a follow-up in which Russell reopened the wound, washed it out and reinserted the implant, the NSW District Court has been told.
Cosmetic surgeon Ron Bezic on Monday, who believes the evidence points to the wound being infected, said Russell's manipulation of the hand during that second procedure “would have encouraged the spread of the bug”.
That includes lifting the skin, shifting the implant and applying pressure.
The infection would have spread both to the surrounding tissue and the bloodstream, and would still occur if a substance such as pus was pressured out of the wound, he said.
“Normally”, a surgeon would remove the implant, wash out the wound, take a sample of the pus to determine what bugs were growing and start the patient on antibiotics.
“That is OK to do, but if you're putting pressure on the wound without any other treatment, that would make it worse,” Dr Bezic said.
A neighbour of the deceased woman told police the woman had complained about pain in her hand, Russell's administration of anaesthetic causing her acute pain and how pus had been “gushing from her hand”, the trial was told.
Those observations, and others from before the second operation, were “very important evidence regarding the presence of infection,” Dr Bezic said.
“It just shows the progression of infection over the 20-day period,” he said.
The woman's later drowsiness and “spaced out” demeanour – in conjunction with her swollen hand – were signs of septicaemia, he said.
Russell's lawyer suggested it was not possible to say whether the hand was infected during the April 10 procedure, based on the available evidence.
“I'm viewing video evidence that is not of a great quality,” Dr Bezic said.
“(It looks) red and swollen to me.
“Redness may indicate infections, you would need to look at the hand more thoroughly.”
The neighbour, whose police statement is yet to be tendered as evidence, is due to give evidence on Monday afternoon.Internet Explorer Channel Network