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May 30, 2001

Complications

Question from London, The United KIngdom:

My mother-in-law, who has diabetes and takes insulin has bowel cancer that has now spread to her stomach. While in hospital she contracted MRSA [Methicillin-Resistant Staph Aureus], and her operation wound took six weeks to heal. Because of this, she could not be started on chemotherapy. After leaving the hospital, she developed gangrene in a leg, and ten days ago the leg was amputated below the knee. The wound is now septic, and she has been told she must have the rest of the leg off immediately. My questions are: What happens when the new site is infected when surely it will be with MRSA? (Her surgeon can't cut her in half, can he -- so what are the options?) Would maggot therapy be a better option than amputation? Is it okay with diabetic gangrene? If maggot therapy is not an option, since her cancer is terminal, with no chance of chemotherapy, would it be best to leave her in peace?

Answer:

I agree that the surgical site is at risk for infection. I am not an authority on maggot therapy to heal wounds. I am afraid I am not going to be much help to you in understanding your mother-in-law’s case. I would encourage you or other family members to speak with her physicians in order to clarify the issues you have questions about.

JTL