A 45-year-old male agricultural worker from Sudan presents with a 5-year history of painless, progressive swelling of the left foot with multiple discharging sinuses. Examination reveals a woody-hard subcutaneous mass with purulent discharge containing black grains. KOH mount of the discharge shows broad, septate fungal hyphae. The diagnosis of eumycetoma (Madurella mycetomatis) is confirmed. Which of the following represents the MOST APPROPRIATE MANAGEMENT APPROACH for this patient, as marked **A** in the diagram?
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