Noma (also known as gangrenous stomatitis or cancrum oris) is a rapidly progressive and often fatal infection of the mouth and face. This disease predominantly affects children between the ages of two and six years old in the least developed countries around the world, primarily in the "noma belt" of sub-Saharan Africa. Noma has also been seen in severely immunocompromised people in the developed world.

A 35-year-old male presented to the emergency department with bilateral forearm wounds. His past medical history was significant for untreated hepatitis C. He was unemployed and homeless. He reported injecting xylazine-laced fentanyl into his bilateral forearms. A physical exam revealed bilateral full-thickness skin wounds from the wrist to the proximal forearm over the ulnar border measuring [Figure 1]. The wounds appeared cavernous with undulated regions of eschar. Further, examination revealed exposed muscle and tendon bilaterally and some exposed muscle of the dorsal forearm compartments. His hand function was preserved.

The patient was admitted to the hospitalist and initiated on broad antibiotic treatment with intravenous vancomycin and piperacillin/tazobactam. His wounds were washed and covered at the bedside, and he underwent surgical debridement in the operating room the following day. Intraoperatively, the eschar layers were removed sharply with a knife until a bleeding surface was encountered. Exposed muscle layers were removed with a curette. The ulna had an intact periosteum. Large-volume irrigation was used to clean the wounds. A negative pressure wound therapy device was fitted to the bilateral forearms. The sponge was changed twice over six days. On a postoperative day seven, the patient was returned to the operating room. Granulation tissue was observed over the ulna, and the wounds appeared clean. The surgeon covered the area with a split-thickness skin graft taken from the thigh. A negative pressure wound dressing was placed over the skin graft. The patient left the hospital against medical advice (AMA) two days following the second surgery and did not follow up in the surgeon's office.

Approximately nine months later, the patient returned to the emergency room with a similar, smaller wound on the left forearm. On exam, both previous skin grafts had healed well, and the new wound was adjacent to the volar border of the skin graft and measured 8x4cm. The wound exhibited a cavernous appearance but did not have exposed muscle. The next day, surgical debridement was performed, followed by negative pressure wound therapy. The day after surgery, the patient left AMA with no follow-up reported since.

https://surgicoll.scholasticahq.com/article/71308-upper-extremity-soft-tissue-wound-related-to-xylazine-laced-fentanyl-intravenous-iv-drug-abuse-a-case-report

A_ intra-operative view showing the dartos myo cutneous flaps harvested from the lateral part of the scrotum.

B_ the dartos myo cutneous flaps are rotated to cover the anterior surface of the shaft and sutured on the midline.

Defect on foot after tumor excision (A). Osteotomies and realignment of segments in L-shape to provide pillar support for two toes (B and C).

Post-operative result after 24 hours (D) and six months post adjuvant therapy (E).

The last stage of rabies is very painful, making it impossible for you to swallow your own saliva since it makes you hydrophobic, which is a defense mechanism for rabies since the virus is usually kept in saliva. The child probably has 0-48 hours to live, the virus is 99.99% fatal, once the hydrophobia starts it becomes 100%

This is a typical case of Teratomatic-Dermoid cyst of the ovary!

Teratoma;

"is a tumour consisting of a mixture of tissues not normally found at that site". This is a bizarre tumor, usually benign, in the ovary that typically contains a diversity of tissues including hair, teeth, bone cells, thyroid etc.

A dermoid cyst is often called a teratoma!

Removal of the dermoid cyst is usually the treatment of choice.This can be done by laparotomy or laparoscopy.

Post debridement surger the hand and wrist where pinned into proper alignment, then covered by a groin flap. Silicone rods sutured to tendon stumps to help future reconstruction shown in last picture.

Context unavailable.

Originally found on Livegore:

https://www.livegore.com/1157/naked-woman-post-mortem-in-progress

Be safe

Happened in India. If it's a repost or needs to be taken down lmk, sorry about the spam uploads

I can't imagine this would feel very good 😬 anyway the image is from reddit and idk what the backstory is. (!Mods feel free to move this if it's in the Wong flair please!)

The child's mother was allegedly shot dead...

Example of a 14-year old female patient with a broad band contracture of the upper extremity.

(a) Preoperatively.

(b) Dissecting the flaps of the five-flap plasty in the elbow.

(c) The defect that remained at the wrist and dorsum of the hand after releasing the scar.

(d) Direct postoperative results.

(e) Result at 12 month follow-up.

(f) Result at 12 month follow-up.

He just vomits blood and everything, in the end he died... of course

I know that this is a well known vid but I neber saw it in here I think so I post it to Show the wpd community this vid