Patient N.V.T, 51 years old, Hanoi, had diabetes but did not know the disease, leading to prolonged and uncontrolled high blood sugar. When arriving at the hospital, all of her feet were in a state of wet necrosis: The necrosis tissue was rotten, bad breath, and infections spread. The big toe had fallen off before.
After the doctor thoroughly removed the necrotizing tissue, the patient's remaining foot liver only reached about 4050%, creating a huge defect - a typical type of damage in long-term diabetic patients due to micro-vehicle complications.
Dr. Duong Manh Chien - cosmetic surgeon at the Central Hospital for Tropical Diseases - said: Prolonged high blood sugar causes damage to the cardiovascular system at the end of the limb, gradually narrowing and making it impossible to send blood to the legs. Anemia will gradually die, starting with dried necrosis and then fall off on its own. When bacteria enter, the transition to wet necrotizing is extremely dangerous, can spread rapidly and threaten life.
Most cases of late admission such as patient T are often "difficult to save": Either amputation, or facing the risk of sepsis.
After controlling blood sugar and infection, the surgical team decided to perform a minor surgery - the only chance to preserve the feet. Doctors took a skin - artery Van from the thigh area and transferred it to the legs to cover the large defect.
The breakthrough of the surgery was the side window connecting technique. Instead of completely cutting off the blood vessels in the leg area to connect the tarpaulin - a method that can reduce blood flow to the feet - doctors only open a small " window" on the mach wall.
The surgery lasted 45 hours. Initial results are very positive, the skin is pink, the blood is well watered, infections are controlled and the surgical site is gradually dry.
Dr. Chien emphasized that surgery only solves the "short" part. The root of the problem is still diabetes. If blood sugar is not well controlled, blockage, necrosis or infection can completely recur.
