A small scratch on his leg while cutting grass brought 44-year-old Mr S from Cambodia to the brink of death. Within just a few days, the wound developed into a necrotic ulcer that rapidly spread to both legs. Doctors in his home country saw no option but to recommend the amputation of both legs to save his life.

His transfer to FV Hospital marked a turning point. After more than a month of intensive treatment, he regained the ability to walk. “When I arrived at FV, I had already said farewell to my wife and my mother; I never imagined that I would one day walk back to my family on my own legs,” he shared upon his discharge.

At Risk of Death Within 24 Hours from Severe Septic Shock

Dr Truong Hoang Vinh Khiem, Specialist Level II, from FV’s Bone & Joint Centre, recalled that the patient was admitted in a critical condition, with both legs ulcerated, infected, and severely necrotic extending up to the groin. Several areas were deeply necrotic, exposing the tendons and bones of the shins and emitting a strong odour. He noted that if the patient had arrived just 24 hours late, he might not have survived.

Tests revealed that the patient was suffering from Cushing’s syndrome, which caused severe immunosuppression. This was the result of prolonged use of high-dose corticosteroid medication to treat psoriasis.

“The manifestations of Cushing’s syndrome include fat accumulation in the trunk and face, muscle wasting, easy bruising of the skin, osteoporosis and fractures, and in more severe cases can lead to heart failure and adrenal insufficiency. The patient’s immune system also becomes weakened. In the case of Mr S, undiagnosed Cushing’s syndrome combined with diabetes led to a severe infection, pushing him into a critical condition,” explained Specialist Level I, Nguyen Thi Thu Huong, MD, MSc –  Endocrinology and Diabetology Unit, Internal Medicine Department, FV Hospital.

Faced with the urgent situation, the team led by Dr Truong Hoang Vinh Khiem, Specialist Level II from FV’s Bone & Joint Centre, were determined to save the patient’s life and “preserve at least one leg”. He was supported in this highly challenging treatment by doctors from Endocrinology, Nutrition, Physiotherapy and other specialties.

Five Surgeries and Multidisciplinary Care Save Patient’s Legs

As an experienced specialist in treating severe necrotic wounds, Dr Khiem expertly led the management of Mr S’s ulcers. He used Vacuum-assisted Closure (VAC) to remove necrotic tissues, performed microsurgical flap procedures to cover areas of muscle loss caused by muscle necrosis, grafted healthy tissue to replace missing parts, and closed the wounds. In total, the patient underwent five microsurgical operations.

At the same time, Dr Thu Huong treated Mr S’s Cushing’s syndrome, managed his diabetes, and supported his immune system so his body could fight the infection. FV’s nutrition specialists developed an appropriate diet plan, combined with hypoglycaemic medication to control his diabetes. Nurses provided round-the-clock care, changing dressings, disinfecting wounds, serving meals, and offering emotional support.

As his condition gradually stabilised, FV physiotherapists guided him through daily rehabilitation exercises.

Overwhelmed with Joy as He Took His First Steps

After more than a month of comprehensive treatment and multidisciplinary care at FV, what once seemed impossible became reality: Mr S was able to stand and walk again. The moment his feet touched the ground, he felt both nervous and hopeful with each step, before bursting into relief and joy while his loved ones watched, overcome with emotion.

“When the Cambodian doctors told me both legs had to be amputated, I was devastated. My only hope was to save my legs, so my family and I decided to come to FV Hospital. On the day I arrived, I said farewell to my wife and my mother, never expecting that I would be able to walk back home on my own legs. I have no words other than my deepest thanks to the hospital staff, especially Dr Khiem, the physiotherapists, and the nurses who cared for me so devotedly and helped me walk again,” Mr S shared on his discharge day.

Dr Khiem noted that it was truly fortunate Mr S was able to keep both his legs, attributing this outcome to his young age, good overall health, perseverance in enduring treatment for such severe infections, and the seamless coordination of the entire medical team.

“When Mr S was admitted, I was not certain whether we could save both his legs. But together, across multiple specialties, we worked to care for his overall health while also focusing on the wounds, determined to do everything possible to preserve both legs. For a young man to lose both legs would have been a deeply tragic outcome, as he still has his whole life and future ahead of him,” Dr Khiem shared.

Around the world, many patients have lost their lives due to seemingly minor infections. In individuals with weakened immune systems, infections can progress extremely rapidly because they lack the natural defences of healthy people. “Any minor wound should be carefully examined by a qualified doctor, treated with appropriate medication, and managed by strict endocrine control,” Dr Khiem advised.

For more information, please contact the Bone & Joint Centre, FV Hospital on (028) 3511 3333, or visit us directly at 06 Nguyen Luong Bang, Tan My Ward, Ho Chi Minh City.