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Family Foot & Ankle

Limb Salvage Surgery

We know how dangerous diabetes can be for your feet. Nation-wide, the numbers are not good. Over 30 million Americans have the disease (whether they know it or not), and the numbers are growing rapidly. Perhaps another 80 to 90 million more have prediabetes, with an elevated risk of developing the condition within the next decade.

That’s why at Family Foot and Ankle Center we have a team of podiatrists dedicated to providing the best in proactive, preventative, and maintenance care for patients with diabetes—from regular checkups, to diagnostic technologies, to skin care, neuropathy treatments, wound care, and more.

Background: Explaining the Problem

Because high blood sugar impairs sensation and circulation in the lower limbs, many with diabetes (about 15%) eventually develop sores and ulcers on their feet that just don’t heal. Without treatment, these wounds can lead to tissue death (such as gangrene) or even deep bone infections. At this critical stage, limb salvage surgery or amputation may be the only available option.

Because such operations are expensive, risky, and can significantly impact quality of life, we urge all our patients to be proactive and never let the condition of their feet deteriorate to such an extent. However, for those who do reach this point, limb salvage surgery may be a last-ditch option for those who wish to prevent an amputation.

The Methods and Goal of Limb Salvage

When tissue death is extreme enough, surgery becomes necessary to prevent the spread of infection and gangrene (and ultimately, to save the life of the patient). For a major amputation, the goal is simply to remove any affected section of the limb to save the rest of the body.

By contrast, a limb salvage operation is geared toward preserving or saving as much of the limb as possible, and may include bone or skin grafts and transplants, synthetic implants, reconstructive surgery, vascular or nerve treatments, and other techniques. Ultimately, the goal is to maintain the highest possible quality of life for the patient, preserve as much limb function as possible, or leave the remaining stump as well suited as possible for an effective prosthesis.

Deciding on Salvage or Amputation

The decision to salvage is not a light or easy one.  Early amputation, while not ideal, has the advantage of being quicker and less risky, with a lower likelihood of complications and possibly a higher long-term quality of life than those with limb salvage procedures that do not produce the desired outcomes.

Microsurgery and other techniques have improved tremendously even in the last decade and success rates are climbing all the time. However, limb salvage is still a difficult and potentially dangerous process, and in many cases it ultimately fails. The infection returns, or the body rejects the implanted tissues, or any number of other problems could occur, all of which could ultimately lead to amputation anyway despite the pain and frustration of multiple procedures. And even in some cases where salvage “succeeds,” function may remain limited.

Complicating factors such as your age, pre-injury leg function, smoking history, nerve damage, and medical conditions such as peripheral artery disease may additionally make limb salvage surgery either more or less likely to succeed, fail, or lead to recurrent problems. Furthermore, the more extensive the damage is before surgery, the more likely an amputation will ultimately be inevitable.

Because the decision on whether to perform limb salvage surgery or an amputation is often not clean cut from a medical perspective, subjective factors, such as your occupation, lifestyle, social support system, and personal disposition, may play a role in helping you make the best possible decision.

Quality Care for Your Diabetic Feet

Of course, the best treatment option is to be vigilant, proactive, and disciplined in your regular diabetic foot care routine. Keep your feet clean, dry, and healthy, fully inspect your feet at least once a day for trouble spots, keep your regular diabetic checkups with our doctors, and seek help at the first sign of trouble. If you follow these steps regularly, your odds of developing ulcers or wounds are very low—diabetic wounds are almost always preventable.

If you do need further help dealing with a more extensive wound condition, please do not delay even a second longer. It could be the difference between losing or saving a limb, and the lifetime of consequences each outcome represents. To set up an appointment, please call Family Foot and Ankle Center at 888-689-3317 to schedule an appointment at one of our five locations in the Cincinnati area.