" Mak cik tak nak kaki mak cik kena potong..bukannya senang dik..nak dapat kaki ni" Makcik Muniati shook her head
We all stared at her in disbelief..Her left leg was already necrotic, most of the muscles were devitalized. The stench of the odor from her leg was filling the whole ward.
" Makcik..makcik sayang nyawa ke, atau sayang kaki lebih? makcik boleh mati kalau biarkan macam ni." Mister Jacob was stern this time
" Apa ni doktor..nak paksa-paksa saya pulak!" She scoffed
My specialist was exasperated. The wound was open for her to see. Even with the extensive
wound that we did, and the muscles, bones and the internal structure being open, she was still adamant on keeping the lower limb..
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Gangrene is a complication of necrosis (i.e., cell death) characterized by the decay of body tissues, which become black (and/or green) and malodorous. It is caused by infection or ischemia, such as from thrombosis (blocked blood vessel). It is usually the result of critically insufficient blood supply (e.g., peripheral vascular disease) and is often associated with diabetes and long-term smoking.
Purpose of wound debridement:
An open wound or ulcer can not be properly evaluated until the dead tissue or foreign matter is removed. Wounds that contain necrotic and ischemic (low oxygen content) tissue take longer to close and heal. This is because necrotic tissue provides an ideal growth medium for bacteria, especially for Bacteroides spp. and Clostridium perfringens that causes the gas gangrene so feared in military medical practice. Though a wound may not necessarily be infected, the bacteria can cause inflammation and strain the body's ability to fight infection. Debridement is also used to treat pockets of pus called abscesses. Abscesses can develop into a general infection that may invade the bloodstream (sepsis) and lead to amputation and even death
NECROTIZING FASCIITIS
necrotizing fascitits is any necrotizing soft tissue infection spreading along fascial planes, with or without overlying cellulitis; - also called Meleney ulcer, NF is severe manifestation of lymphangitis that progresses in a frightening manner within a few hours; - tissue necrosis develops rapidly behind advancing wall of inflammation that limits penetration by antibiotics;
Below knee amputation
Amputation is the removal of a body extremity by trauma or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene
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