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  • February 1, 2010
  • Need for More Amputations Due to Infection

  • Dr. Sarani reports on the difficult situation many patients now face in Haiti, as infections at amputation sites make it necessary to remove more of the affected limb.

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].

Penn surgeons perform operation in Haiti

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.


This report was written by Michael Ashburn, MD, MPH, MBA, during his participation in Haitian relief efforts through Penn Medicine in coordination with Partners in Health.


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