نافع لغيره – BeNeFiCiaL tO OthErS

Take good care of thy limbs

The Surgery posting is about to end for my batch. Only a week remains before the end posting examination. After this, Obstetric and Gynaecology will greet us with warm welcome hopefully.

Surgery is one of the challenging subjects in final year. It concerns with the visible diseases seen macroscopically like ulcer, goitre and carcinoma. More or less, it has a strong relation with operations as far as the name concerns. Surgery is a branch of medicine which requires a good knowledge of anatomy. Yes you are right. The stuffs that we learned in first year where we know ourselves as a perfect creation by the God.

What ? Already forgotten the blood supply of the stomach ? Then don’t be a surgeon.

This morning I had the chance to see one of the operation of surgery department which is amputation of the left leg. The patient is an old female around 80 years of age. The right leg had already been amputated previously. Due to gangrene, the left leg had to be amputated. She had atherosclerosis which may be the cause for the gangrene. Atherosclerosis causes the dry gangrene of the foot due to gradual occlusion of the arterial circulation. The affected part becomes dry, mummified and discoloured in appearance.

Back to the operation theatre, the surgeon cleaned the area to be removed before marking that area as guidance. After that they started the procedure by cutting the skin, superficial fascia and deep fascia. Muscles and tendons were cut with an electrical devices. The smell of burnt flesh filled the air. I am feeling a bit nervous to see such ‘cruel procedure’ as I felt pity to the patient to go through such operation. But no other choices remaining other than this to save her life.

About 40 minutes later roughly, the tibia was seen clearly. After separating the soft tissues from the bone, it was supported with a towel before cutting of the tibia was done. At first place, I thought they will use the saw to cut the bone. The act of cutting the wood like what the carpenter does came into my imagination. I was wrong.

The surgeon used a small wire with 2 T-shaped rod at the end of the wire to cut the tibia. The wire is sharp enough to separate the hard bone. Even when I told my friends about it, they were shocked to know the method as they also had the same thought of using the saw. (A small one, not the big ok..)

The procedure ended in approximately 1 hour and 35 minutes. Before I forgot, it was a below knee amputation (BKA). The right leg also had the same type of amputation.

Usually, amputation of the leg is related to diabetes when it is in chronic state. The leg, due to high blood sugar serves as good medium of bacteria growth. It is more prone to various infection. Due to atherosclerotic process, there will be stasis of blood (restriction of blood movement). As a consequence, ischaemia occurs which lead to the gangrene.

As we still have a healthy feet, do take care of it properly. Do not take too much sugar in our diet to avoid the occurrence of diabetes.

It is said that, prevention is better than cure right ? So lets start from now for a better life in the future. (“,)


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