Team of specialists at Al Zahra Hospital get together to save the foot of a 42-year old Patient

Saving a patient from ‘amputation’ With Complicated Surgeries Now Facilitated in the Country, Patient’s Choose to Avoid Travel

Recently, a team of doctors at Al Zahra Hospital Sharjah were tasked with treating a 42-year-old patient; Ahmed Mansouri, name changed for confidentiality purpose, who was a long-term diabetic. The patient had developed severe infections in both feet. His left foot in particular had suffered considerably; deteriorating from ongoing complications. In a bid to save his foot, Mr. Mansouri was offered the opportunity to undergo ‘free flap’ surgery, the first of its kind in Al Zahra Hospital Sharjah. The surgery, which would require a team of highly trained specialists. The patient underwent a 12-hour operation with intensive post op follow-up on the Intensive Care Unit and subsequently on the normal wards. He was discharged a few weeks later walking on his feet with the operation a success 

Initially under the care of the General Surgical team, Mr. Mansouri was subsequently referred to Dr Harpal Jadeja, a UK trained Consultant in Orthopaedics and Trauma whose specialist interest included the treatment of diabetic feet. Surgery was performed to clean the wound and it was found that the infection had destroyed a significant number of tendons and skin. Dr Harpal requested the input of Dr Nadeem Akhtar, a UK trained Consultant in Plastic and Reconstructive Surgery. Both surgeons were concerned that the amputation could be the only option if they could not control the infective process. To bring infection under control, extensive debridement were carried out over a number of weeks and the wound dressed regularly.  Input was also obtained from Dr Brian, Consultant Endocrinologist and Dr Hussam, a Consultant in Infectious Diseases. This ultimately resulted in a defect of 13 by 10 cm with exposed bones and the loss of one of his toes.

Image: The left leg which was saved

Having experience with such cases in the UK, both Dr. Harpal and Dr. Akhtar discussed the treatment options with the patient. After extensive deliberation, free flap surgery was finalized to treat this condition. Free Flap surgery is an advanced Plastic Surgery technique where tissue is transferred from one part of the body to another by taking the tissue with its blood supply and connecting it to another blood supply in a different area of the body. ‘It was the first surgery of its kind at the hospital, and both the patient, his family and the entire team of medical staff which consisted of an Orthopedician, Endocrinologist, Radiologist, a General Surgeon, Physiotherapist and a Plastic Surgeon, were delighted with the results’, said, Orthopedic Consultant Dr. Jadeja. He also added, ‘Given the decline of the patient’s foot and the onset of complications, we were proud to successfully treat Mr. Mansouri’s foot using the free flap surgery, where a donor of healthy tissue from the patient’s forearm was transferred to the infected area.’

Foot-care for diabetics should be taken seriously, and in the case of any doubt, it’s always best to seek medical advice from a specialist. Whilst there are often alternative procedures, the loss of the best option can be devastating for both patient and medical team. Seeking specialist help as early as possible greatly favours the odds for having such a complex procedure completed at the highest rate of success.

Mr. Mansouri commented, “As my condition was already quite severe, I wanted to remain hopeful, but the possibility of amputation and further infection was still a reality I had to consider. Other than the extreme of amputation, there were prosthetics and plastic surgeries. Amputation in particular would have affected my confidence and mobility moving forward as a father. I had full faith that the team of doctors would do their best to work on my foot via the ‘free flap surgery’, and I appreciated the professionalism, support and honesty with which the doctors and surgeons openly told me that the process didn’t guarantee a 100% success. Since the operation, I’ve been in good health, and have been following a regimen of daily mobility exercises, and more mindful nutritional choices, along with post-operation medication and care to speed up the healing process.”

Both doctors worked in tandem with the medical personnel at Al Zahra hospital to give Mr. Mansouri world class treatment. Following the procedures, they finalized their comments, explaining the potential severity, learning curve and future treatments for patients in similar positions as well as those suffering from major lower limb trauma and who could potentially be saved from amputation if free flap were available. They echoed a desire to let the public be informed of the importance of accurate diagnoses, and the possibility of cases such as Mr. Mansouri’s being treated in the UAE as a team of highly qualified doctors from the Emirates, Gulf and UK are available to work meticulously on future cases.
 
About Al Zahra Hospital: Al Zahra Hospital Sharjah is one of the largest tertiary private hospital in the Emirates of Sharjah with all medical and surgical specialties under one roof. The hospital has 137 inpatient beds, 7 Operating Theaters, 24 hours emergency services and ambulance support. The Hospital also offers state-of-the-art radiology, pathology, intensive care and critical care services.
Our well-trained clinicians are committed to provide highest standards of quality and medical excellence. We endeavour to provide individualized care and delightful healing experience to each one of our patients, every time.