Diabetic limb salvage is the term used when doctors from multiple specialties work together to prevent leg amputation and limb loss for their patients. About 10% of the United States population suffers from diabetes. Keeping these patients healthy and active is the goal of diabetic limb salvage.
Some key facts on Diabetes and Wounds
- 15% of patients with Diabetes will develop a foot ulcer in their lifetime
- 12 weeks – the average time to heal a diabetic foot ulceration
- 43.4% – the 5-year survival rate following a leg amputation due to a diabetic wound
Diabetics often experience issues with blood circulation, muscle contractions, and nerve response. As a result, their bodies are more prone to developing wounds and sores on the feet and legs. They have a hard time healing wounds that would otherwise be considered minor. The most common lower body wounds that diabetic patients experience are foot ulcers and subsequent infections to the surrounding skin and underlying bone. The progression of these infections leads to more than half of the non-traumatic leg amputations that are performed by doctors each year. Another diabetes-related issues that can lead to amputation are peripheral neuropathy (when the nerves that carry messages to the
the central nervous system is damaged or diseased), and peripheral vascular disease, or PVD for
short (when the blood vessels become narrow or blocked, limiting circulation).
Amputation is the last case option in patients with chronic ulcers and infections that do not
respond to non-surgical treatment. Limb salvage is not a specific treatment, but rather a blanket
term encompassing all procedures, interventions, and treatments that attempt to preserve the limb and retain limb function.
Diabetes is a complicated disease that requires a team of professionals to treat and in the case
of diabetic limb salvage, multiple different physicians and specialists will be consulted to address
treatment and recovery.
In order to determine the extent of your condition and to help put together an accurate diagnosis, doctors may schedule an Xray, an MRI, an ultrasound to assess blood flow, or possibly an angiogram, which is a special type of x-ray that involves injecting a dye into the bloodstream to help illuminate any existing blockages.
There are several different treatment options commonly used to help avoid amputation:
- Stenting is when a small tube is placed in the artery to aid blood flow
- Bypass is when a vein is moved, or a tube is inserted to circumvent the blocked area and
- bring blood to where it is needed
- Atherectomy is when plaque is removed from a narrow artery
- Angioplasty pushes the plaque against the walls of the artery opening the blocked area
- Surgical closure or offloading of the wound area
If the infection is indeed the culprit, debridement is the term used for the removal of damaged or
Outside of surgery, there are a few non-invasive treatment options that will likely be employed
before an operation is considered, some of these include:
- Appropriate Wound Care
- Biologic agents in the clinic to help with the healing of wounds
- Glycemic control
- Gait adjustment
- Orthopedic inserts or customized footwear
- Casting to protect the limb
- Hyperbaric oxygen therapy
When the above therapies fail, surgery can help to heal and prevent wounds. Recovery after a procedure like the ones mentioned above will vary from patient to patient, but in most cases, you will need to stay off your feet post-op, and you will be fitted with a boot or brace to help stabilize the reconstructed area. From there your team of physicians will put together a recovery program personalized to your needs, and schedule multiple follow-up appointments to monitor your recovery.
If you have questions or concerns regarding your own related symptoms or think that surgery
might work for you, please contact us. We look forward to offering you the best possible care for your needs and doing everything we can to preserve your freedom and comfort.