|High voltage electrical burn|
As Margaret Atwood stated, "An amputation is like a divorce, you survive it but there's less of you". I saw the truth of this in Nigeria about a year ago. I was brought into a room where a young man was lying. His relatives were huddled around him. The room smelled terrible-the smell of rotting flesh. The poor boy accidently touched a high voltage wire. His left arm was instantly destroyed. The electricity discarged through his feet and his right leg was necrotic from the ankle down. The relatives waited days before they brough thim to the hospital and when he got there he was septic. His urine was dark from rhabdomyolysis. He was lucky to still be alive. After hydration, we took him to surgery and removed the arm at the shoulder. We also amputated the right leg below the knee. We left the wounds open in preparation for a second look operation. Eventually, we operated four times before we could close the wound.
The patient was so depressed after the first surgery that his sadness was palpable. After he got a crutch and could walk, he snapped out of his funk and slowly improved-both mentally and physically.
This was not the first time we ever performed such a terrible amputation. In 1999, I met a very sweet lady. Like many of my patients, she had a very large tumor and it had been operated on previously. The tumor was so big that she could not lift her arm. I offered her the only possible treatment-which was a forequarter amputation-amputation of the arm, clavicle and scapula. We operated and the surgery went very well.
The tumor was a liposarcoma-a malignant sarcoma that arises from fat cells. She lived five more years until she died from metastatic disease.