Full Name: Big Black Monokoru Boo

Age: Less than 1 year old

History: Patient initially presented with mild loss of weight with incontinence of stuffing. Previously noted to have a perforation at the dorsal surface of his body causing continuous leakage of stuffing. T+S done under local about 2 month ago. However, in the past 2 weeks, noted that patient persisted to have weight loss and a flattened look. On examination, patient looked ill, spiking fever from wound dehiscence and hemodynamically unstable due to hypostuffinaemia. Patient was then fasted and posted for emergency surgery.

Diagnosis:

1. Cachexia and sagging due to severe hypostuffinaemia

2. Sepsis secondary to wound dehiscence

Surgery: Wound debridement, body lift and re-stuffing

Surgeon: Jellio’ MD

Date of surgery: 26/05/2009

Duration of surgery: 1840 H – 1945 H

Procedure:

1. STO done on old wound.

2. Skin cleaned and drapped.

3. Lignocaine 2% infiltrated at proposed op site.

4. Wound incision extended and edges trimmed.

5. Wound irrigated with saline and hydrogen peroxide.

6. Stuffing consisting of 2 rolls of Otoban shredded, fluffed and optimised.

7. Stuffing inserted into all four quadrants under aseptic technique.

8. Skin closed with interrupted sutures using Silk 3/0.

Post-op orders:

1. Continue IV antibiotics.

2. Strictly light duty for 6 weeks.

3. Not to be squashed or sat on by humans in the near future.

4. Wound inspection Day 3, no need STO.