I had tried very hard to keep myself update on my job, however sometimes, I had doubt…. Thank god, someone had invented something called the internet.
We had this osteomyelitis case who was referred to a medical center for further management. There was a great chance for the patient to get the disease as she had rammed her bike into a drain and the bone was soaked in the drain for sometimes before she was dragged out. A simple trauma case who undergone surgery in our setting...
It should have been ok eventhough osteomyelitis developed. However we had pushed ourselves to the current ground. Proper communication was not done pre-ops - no one had explained the risk to the family. When the wound broke down and pus was pouring out from it the family was still hoping for a forever remedy - the family was polite : I just don't care how you all fix the problem, just healed the pt....
The implant was removed and however a plate was re-planted on the second debridement. And weeks after discharge, pus was noted from the scar again...Well, this time, the patient was referred to a bigger hospital up north ... and more shoking news came later -osteolytic lesion was noted (so rapid...) . We reviewed our film and found that no xray was repeated on the latest admission...well, the worst is not another suit as one of the close relative of the patient was a ex-convict ( man-slaughter....)...
For a moment I was a little bit shock when I heard the whole story as it was not the 1st time for the attending doctor to do so…(the last pt expired after a severe noscosmial infection) .
I had a discussion with Lem and we had re-confirmed over the net that the concept of removing the implant in an osteomyelitis situation was appropriate.
It is impolite to criticize our colleague…but I still felt someone should talk to him…..
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