Amputation is one of the most devastating consequences of diabetes. In fact, more than 60 percent of non-traumatic lower-limb amputations occur in people with diabetes, and one diabetes-related amputation occurs in the world every 30 seconds. In addition, mortality ratesincrease with amputation. TMC’s goal is to “save a limb, save a life,” says Karen Reinhard, NP, a member of TMC’s Limb Salvage Team.
Patients with diabetes often suffer foot problems because of myriad complications. Poor circulation and nerve damage lessen the body’s ability to feel pain in the foot or detect injuries. Even tiny cuts or ingrown toenails, left untreated, can cause serious tissue damage that may require amputation.
TMC’s Limb Salvage Team began last December and is comprised of vascular and podiatric surgeons, nurses, technicians and registered dieticians available to all patients with a lower-extremity ulceration. This combination of specialties arises from the concept of “toe and flow,” in which podiatric surgeons manage the non-vascular issues of the foot, and vascular surgeons perform the necessary measures to ensure adequate circulation for healing.
The team utilizes cutting edge methods such as rapid endovascular interventions, synthetic skin substitutes and prophylactic elective surgery to eliminate biomechanical foot abnormalities.
“I am incredibly pleased that we’ve developed a team of professionals who have been successful in preventing amputations in these patients,” says Dr. Gulshan Sethi, Section Chief of Cardiothoracic Surgery. “You need a vascular surgeon who can evaluate blood flow and find out if there is a blockage. Many of these patients – 60 to 70 percent – have cardiovascular disease. There is not enough blood flow to make an ulcer heal.”
“Losing a limb is not only a major limitation to a patient, it’s functionally devastating,” Sethi says. “We can do a better job. Doctors tell their patients what they need to do to improve, but if we have a team of people seeing the patient together in a combinedclinic, it can be very strong.”