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 is very high and after amputation the leftover 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.
Pain, discharge, wound dehiscence, pressure ulcer due to prominent bone.
Patient 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.
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.
Patient is discharged on daily dressing and follow up as out patient with advice of physiotherapy regularly. Then after 3-4 months of stump healing referred to prosthetic limb department for a prosthetic limb.
Outcome depends on the location and size of the fistula and status of surrounding tissues. Although most of the fistula closes after the surgery, some may recur and requires further surgery.
It usually takes less time than the original hypospadias repair and completes in less than an hour.
The surgery is performed under general anaesthesia and as a day care procedure. Patient can go home the same day after recovery from anaesthesia.
The most common complication is recurrence of the defect. Others complications include infection, difficulty in urination and stricture formation
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