Burns of the hands and feet can lead to severe contractures and deformities. One woman in her late 30s came to BMC with a large wound on her arm. It had developed at the site of a 15 year old burn wound which had “glued” the back of her hand to her wrist. The wound had heaped up edges and was becoming necrotic in the middle. It looked like cancer. Chronic wounds and burns can develop into a type of squamous cell carcinoma (a skin cancer) called a Marjolin’s Ulcer.
At first, she requested that I release the scar to allow her to use her hand again. Unfortunately, her only option for relief from pain and an end to this wound would be an amputation. She took a day to consider her options and then finally agreed.
On the day that I did the amputation, while laying on the operating table, she called me to her side. She made me swear that I was cutting below the elbow so that she would still have a small stump beyond the elbow. If not, she feared she would not be able to hold the stirring stick used in preparation of the staple food around here. I assured her and performed a below elbow amputation.
She has healed well, is without pain, and appears to be doing very well.
Here are some marjolin ulcers I’ve seen on other patients:
