Mr. G and his Chronic Wound

One of our patients is a 76-year-old man named Mr. G.  A tall Congolese with wide eyes, Mr. G had a shallow wound on his thigh shaped like Lake Michigan that extended from his knee nearly to his buttock. The sight of it was overwhelming, a pool of red flesh with no hope of being covered again by skin. Weeping blood and fluid, the wound had plagued Mr. G for over two years. 

Although you'd never guess it from this photo, when Mr. G first arrived he was emaciated and barely able to move because of the pain in his leg. He had to be carefully carried in a stretcher and was basicallly paralyzed from the waist down. Though his familly cared for him faithfully, you could tell his spirits were crushed from having this wound for so long.

Above is a photo Mr. G's lovely wife, Mrs. G.  She and other members of Mr. G's family transported him over a hundred kilometers to our hospital because they had heard of Dr. Tenpenny's surgeries.

Dr. Tenpenny says hello.

Dr. Elliot Tenpenny is a Mayo-trained ER doc who has almost entirely taken over surgery here at Pioneer Christian Hospital. Dr. Tenpenny came here after many months of jungle-surg training with veteran Dr. Warren Cooper of the DRC. Dr. Cooper's blog can be found here: http://warrenandlindseycooper.blogspot.com

When Dr. Tenpenny came to the hospital, he brought a set of skin-graft tools which he promptly put to use.

Hard at work, here is Dr. Tenpenny doing his first skin graph at Pioneer Christian Hospital.

After a few successful skin graphs, word got out and the hospital experienced a steady stream of men and women with enormous, chronic wounds.  And when I say "chronic," I mean it; many of these patients had been afflicted and crippled for years. Many of these lacerations make you shiver to look at them: shins with exposed and rotting bone, foot-wounds cut down to the tendons, and always, always plenty of the pus from infection.

When he came to us, Mr. G was malnourished to the point of skin and bones. His body had consumed itself trying to heal a wound that had acted a black hole for energy and nutrition. Dr. Tenpenny put Mr. G on a stict diet of densely nutritional food called plumpinut, a sticky combination of vitamins and peanutbutter. After a few weeks of nutrion and dressing changes, Mr. G. looked healthier and his wound was ready for an operation.

As far as photos go, I will skip over his grusome original condition. You can get an idea of its original size from this picture taken a week after the operation.

The pinkish, mesh-like parts of the wound are patches of skin that have been grafted from the right thigh which is covered by white gauze. The procedure is simple: Dr. Tenpenny uses a noisy peeling-machine to take a layer of healthy skin from someplace on the body, often from the thigh. He then puts this skin through a mesher which punctures the skin and allows it to be stretched out like a chain-link fence. Dr. Tenpenny then spreads the meshed skin over the raw flesh and we all pray for the skin to stick and grow. 

Above is a picture I took a few hours ago. Notice how the previously fleshy gaps have been filled in with healthy skin. The pink wound on his right thigh will soon regain its pigment. 

After his surgery and after the skin began covering the wound, it took some time for Mr. G to realize he was healed. He hadn't walked on his own in years, and at his age he probably didn't have much hope of walking in the future. I am glad to say that Mr. G is now walking around on his own and, Praise God, will be going home soon.