What should have been a busy day turned out to be fairly light. We anticipated doing 10 cases today but 4 were cancelled because the patients refuse to have their BKA [below-knee amputation] converted to AKA [above-knee amputation].
Photo provided by Samir Mehta
Unfortunately, the grossly infected and necrotic nature of these wounds makes this procedure inevitable. Still, explaining to a patient why the guillotine BKA that was performed up to 2 weeks ago did not work and why he/she needs another amputation is not easy - particularly after one takes into account the language, cultural, and racial rifts between us and the patients. Fortunately, the local surgeon, Jean Louis, has been able to explain the necessity of these procedures to the patients.
Our greatest concern now remains controlling infection and performing definitive operations that allow for closure of the wound. Open wounds here get infected - it's just a matter of time.