Sreng Seng, a 44-year-old Cambodian man, arrived at FV Hospital in critical condition. Dr. Truong Hoang Vinh Khiem, from the Orthopedic Trauma Department, described the patient's legs as severely infected, ulcerated, and necrotic, extending up to his groin. The deep necrosis exposed tendons and bones in his lower legs, emitting a strong odor. Dr. Khiem emphasized that had Sreng Seng arrived even 24 hours later, his life would have been in grave danger.
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Dr. Truong Hoang Vinh Khiem performs microsurgery to remove necrotic tissue and save Sreng Seng's legs. Photo: FV |
Dr. Truong Hoang Vinh Khiem performs microsurgery to remove necrotic tissue and save Sreng Seng's legs. Photo: FV
Tests revealed Sreng Seng had Cushing's syndrome, a condition causing significant immune deficiency. This was a result of prolonged high-dose corticosteroid use for psoriasis treatment.
Dr. Nguyen Thi Thu Huong, from the Endocrinology Department, explained that Cushing's syndrome manifests as fat accumulation in the torso and face, muscle atrophy, easy bruising, osteoporosis, and bone fractures. In severe cases, it can lead to heart and adrenal gland failure. Sreng Seng's undiagnosed Cushing's syndrome and diabetes contributed to the severity of the infection, pushing him into critical condition.
Faced with this emergency, Dr. Khiem and the orthopedic trauma team were determined to save his life and "at least one leg". The multidisciplinary approach involved endocrinologists, nutritionists, and physiotherapists working alongside Dr. Khiem.
Five surgeries and a multidisciplinary approach save both legs
Dr. Khiem, an expert in treating severe necrotic wounds, employed vacuum-assisted closure (VAC) to remove dead tissue. He then performed a series of 5 microsurgeries, using skin grafts to cover the areas where muscle tissue had been lost due to necrosis. Healthy tissue was grafted onto the affected areas, effectively covering the wounds.
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Sreng Seng recovers quickly at FV Hospital. Photo: FV |
Sreng Seng recovers quickly at FV Hospital. Photo: FV
Concurrently, Dr. Huong treated Sreng Seng's Cushing's syndrome and managed his diabetes to boost his immune system. FV's nutritionists designed a tailored diet, along with medication, to control his blood sugar levels. Nurses provided round-the-clock care, changing dressings, ensuring hygiene, and offering emotional support.
As his condition stabilized, physiotherapists guided Sreng Seng through daily rehabilitation exercises.
First steps to recovery
After over a month of comprehensive multidisciplinary care, Sreng Seng took his first steps. He described the moment his feet touched the ground as filled with both nervousness and overwhelming joy, bringing his family to tears.
Sreng Seng had been devastated when Cambodian doctors advised amputating both legs. His sole desire was to keep his legs, leading him and his family to seek treatment at FV Hospital. "When I arrived at FV, I said goodbye to my wife and mother," he shared upon discharge. "I never thought I'd walk again on my own two feet and return to my family."
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Sreng Seng takes his first steps. Photo: FV |
Sreng Seng takes his first steps. Photo: FV
Dr. Khiem acknowledged Sreng Seng's good fortune in retaining both legs. His youth, overall health, and the team's coordinated approach were key factors in overcoming such a severe infection. "When Sreng Seng was admitted, I wasn't certain we could save both legs," Dr. Khiem admitted. "But our multidisciplinary team addressed both his overall health and the wound treatment with determination. A young person losing both legs is tragic, considering their future."
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Dr. Truong Hoang Vinh Khiem. Photo: FV |
Dr. Truong Hoang Vinh Khiem. Photo: FV
Globally, minor infections can be fatal, especially for those with weakened immune systems. Because their defenses are compromised, infections can spread rapidly. Dr. Khiem advised that any small wound should be thoroughly examined by a medical professional, treated with appropriate medication, and accompanied by careful endocrine monitoring.
The Dan
For more information, contact the FV Hospital Orthopedic Trauma Department: Phone: (028) 3511 3333, or visit 06 Nguyen Luong Bang Street, Tan My Ward, TP HCM (former District 7).
