I need help to manage a patient.
This 45 year old lady came to us with a very bad ulcer of her left wrist. And it is stinking very bad. It seems that there are maggots inside.
The X-Ray shows dislocation of the metatarsophalangeal and distal interphalangeal joints of the thumb. There appears to be gas gangrene too.
We tried our best to send them off to a higher centre. They are only willing to go home if nothing can be done here.
The additional challenge is that she has a hemoglobin of 5 gm%. And an ESR of 150 mm/hr. And no evidence of diabetes.
My plan is to do an amputation as soon as we get couple of pints of blood.
Any other choice . . . I would appreciate responses . . .