When there is blackening (gangrene) of toes, feet or legs and if there is vascular compromise with delayed presentation of patient then chances of amputation are very high and after amputation the left-over limb is called the stump.

 Sometimes this stump wound gets infected or doesn’t heal or the bone gets prominent due to inadequate soft tissue coverage, so this stump is refashioned with debridement and wound closure.

SYMPTOMS

Pain, discharge, wound dehiscence, pressure ulcer due to prominent bone.

TREATMENT

Patients can be admitted for 1-2 days, or it can be done in daycare.

Requires local anesthesia for toes and regional or general anesthesia for feet and legs.

PROCEDURE

Refashioning of stump by trimming and debriding the bone and unhealthy soft tissue then providing adequate soft tissue cover over the bone and stump closure.

POST-OPERATIVE MANAGEMENT

Patient is discharged on daily dressing and follow up as outpatient with advice of physiotherapy regularly. Then after 3-4 months of stump healing referred to prosthetic limb department for a prosthetic limb. 

 

Written by: Dr Ali Adnan

Copyrights: Pakistan association of Plastic Surgeons