A couple from Nepal got the shock of their lives when they were told that their newly born child had been diagnosed with severe cellulitis, resulting in gangrene (necrosis) of the entire skin over the forearm. However, doctors at Bai Jerbai Wadia Hospital for Children in Mumbai successfully performed a complex multiple-staged surgery thus preventing amputation.
Doctors said that the baby girl’s skin over the entire forearm had turned black and the parents were advised removal of limb. Timely surgical intervention, intensive care support and efficient wound care ensured that she remained stable and her hand could be salvaged.
The child’s father, Abdul Awwal, from the Nepal-Uttar Pradesh border married a woman from Nepal. Out of their six pregnancies, they lost four children. On birth, their sixth child had severe cellulitis which resulted in necrosis. She was shifted to a renowned hospital in Kathmandu, which recommended amputation. Not willing to disable the child, the couple came to Mumbai where they have relatives.
Dr Nilesh Satbhai, the consultant plastic, hand and reconstructive microsurgeon at Wadia Hospital decided to salvage the limb. He and his team planned for wound cover and reconstruction at multiple stages. After multiple wound washes, a large abdominal flap was taken for the surgery when the child was just one month old. As a result, the anaesthesia management was also extremely challenging.
The abdominal flap was maintained in position for three weeks and divided in two stages; the final flap was set after ensuring that the entire wound was covered on both sides of the forearm. All these surgeries were done in a span of five weeks.
"The child is stable and achieving normal developmental milestones. Secondary reconstructive procedures will be needed for further function as the child grows up. Not treating her at the right time could have led to amputation and lifelong disability," the doctor said.
Crediting the entire team, Dr Minnie Bodhanwala, CEO of Wadia Hospital said that the procedure was precise and innovative. "We are elated to have saved this baby from lifelong disability and helped her regain her hand function," she said.
