Posted By :  Admin1

Mumbai: Bai Jerbai Wadia Hospital for Children successfully conducted a complex, multi-staged surgery to rescue the forearm of a two-month-old girl from Nepal, averting the need for amputation. The child had developed severe cellulitis in her left forearm at birth, leading to a subsequent infection that caused necrosis of the entire skin in that area. Despite recommendations for limb amputation, timely surgical intervention, intensive care, and effective wound management ensured the child's stability and preservation of her hand. Dr. Nilesh Satbhai, Consultant Plastic, Hand, and Reconstructive Microsurgeon, led the critical surgery alongside his team. A newborn baby girl was brought to Wadia Hospital three weeks after her birth, having been born in Nepal. Her mother had a history of difficult pregnancies, having lost four out of six children previously. The infant had been admitted to an ICU in Nepal, diagnosed with severe cellulitis leading to necrosis of the skin on her entire left forearm, causing her condition to worsen. Despite being transferred to a larger hospital in Kathmandu, where amputation of the left upper limb was recommended, the parents were unwilling and opted to seek further treatment at Bai Jerbai Wadia Hospital For Children in Mumbai.

Dr. Nilesh Satbhai, Consultant Plastic, Hand, and Reconstructive Microsurgeon at Bai Jerbai Wadia Hospital for Children, noted, "Upon arrival, the child was promptly admitted to the pediatric intensive care unit (PICU) for resuscitation. Through rigorous medical management, we successfully stabilized the child's condition over the following days. While the exact cause of the skin necrosis remained unclear due to incomplete history, cellulitis, a bacterial skin infection, was suspected. Typically caused by Staphylococcus or Streptococcus bacteria, cellulitis presents as painful, red, swollen areas on the skin. Treatment primarily involves antibiotics, which are usually effective. However, untreated or antibiotic-resistant cases can rapidly deteriorate, leading to severe complications such as necrotizing fasciitis, a flesh-eating disease that affects deeper layers of the skin and surrounding tissues, potentially resulting in gangrene. In severe and irreversible cases, amputation may be necessary. Dr. Satbhai explained, "Upon the child's admission, we immediately opted for limb salvage through swift action. Once the medical condition permitted, we proceeded with wound cleaning, necrotic tissue removal, and infection source reduction. Our strategy involved multiple-stage wound coverage and reconstruction. Following the initial wound debridement, we conducted several wound washes before employing a large abdominal flap to cover the majority of the forearm wound. Despite the child's young age of just one month, anesthesia management for this major surgery proved exceptionally challenging and critical." He continued, "The flap remained in place for three weeks, with division performed in two stages. Final flap setting occurred only after ensuring complete coverage of the entire wound on both sides of the forearm. All surgeries were completed within five weeks. Presently, the child is stable and progressing through normal developmental milestones, with her hand saved thanks to timely surgical intervention and wound coverage. As she grows, additional reconstructive procedures will be necessary for further function. Failure to treat her promptly could have resulted in lifelong amputation and disability."

Dr. Minnie Bodhanwala, CEO of Wadia Hospital, remarked, "The intricate surgery performed to salvage this baby's limb underscores our exceptional expertise and utilization of advanced technology. Our team's tireless efforts in meticulous planning and execution, coupled with a focus on precision and innovation, enabled us to offer hope in what initially appeared to be an impossible scenario. Through the application of cutting-edge techniques and state-of-the-art equipment, we were able to surpass limitations and prevent lifelong disability. We are overjoyed to have rescued this baby and aided in restoring her hand function." 

Expressing gratitude, the patient's father, Mr. Abdul Awwal, reflected, "Under the skilled leadership of Dr. Satbhai, our baby's fragile forearm was spared from the looming specter of amputation. Witnessing our little one confront such a formidable challenge at such a tender age was a harrowing experience. Even at the largest hospital in Kathmandu, we had lost hope upon receiving the recommendation for amputation. Dr. Satbhai's expertise and quick decision-making bordered on the miraculous, as he deftly navigated the complexities of the situation with precision and care. Our journey with Wadia Hospital has been one defined by hope, resilience, and profound gratitude for their unwavering commitment to preserving our baby's forearm. We are immensely grateful to have chosen this path. As a token of our appreciation, we have decided to name our child ‘Tamannah’."