Multidisciplinary approach in fasciltating prompt consent for amputation

Introduction: Consent for ablative surgery is commonly difficult to obtain in Nigeria, thus early discussion of management plan with the patient and their relatives by the healthcare providers managing the patient facilitates early and easier consent process. Disease conditions that may warrant amputation like gangrene, crush injury or malignancy also presents consent challenge even when the patient and relatives know the consequences of delay. Thus the need for multidisciplinary approach in facilitating consent. A 63 year old man who had a recurrent soft tissue sarcoma of the right arm, was referred to our clinic following recurrence. He gave consent for a right shoulder disarticulation at the first clinic visit. He was optimized and subsequently had the surgery followed by adjuvant chemotherapy weeks after. The Patient did well and has been regular on clinic visits. Conclusion: Knowing the natural history of any disease condition and treatment at the different stages of the disease, prepares a patient for the decision to give consent for any treatment at each stage of the disease. The repeated discussion of the treatment plan with the patient helps patients to quickly consent to treatment options as the disease evolves thus the need for multidisciplinary approach. Recommendation: It is recommended that active participation of all the specialties managing any given patient in obtaining consent. The treatment algorithm should be explained early to the patient in the course of management of the patient to prepare him or her for any difficult decision at any point in the management.