 So this is a patient with a large ulcer who has completed antibiotic treatment and the ulcer is still persistent, allowing the ulcer to heal even if it will lead to severe contracture and deformity. So it's advised that surgical intervention is the method of choice and here you excise the wound, then you apply a skin graft. And then you splint the joint, in this case the elbow joint, in such a way that the healing will not lead to any deformity and after surgery in bed the patient had the limb elevated and when the wound is normally inspected after one week and if the graft ticks then he continues or he starts with physiotherapy.