What is Diabetic Limb Salvage?
A diabetic limb is an extremity adversely affected by diabetes. The limb may develop wounds that become infected and in extreme cases can develop gangrene necessitating amputation. Diabetic limb salvage is a medical program aimed at preventing the amputation of a diabetic limb. This program may include inpatient and outpatient services and require multiple specialists to address the needs of the patient.
Who is at Risk of a Diabetic Limb?
Diabetic foot ulcers or infections are characteristic features of a diabetic limb. The longer the ulcer remains unhealed, the more the infected area threatens the health of the entire limb and subsequently increases the chances of amputation.
You are also more likely to develop a diabetic limb if you:
- Have uncontrolled diabetes
- Are over the age of 60 and have hypertension
- Have suffered kidney failure for a long period
- Are a heavy smoker or have had a history of heavy smoking
- Have progressive pain in your legs especially while walking or running
- Have diabetic neuropathy
Significance of Diabetic Limb Salvage
People with diabetes are prone to nerve damage or numbness is known as neuropathy and impaired blood circulation. Wounds to the limb may not heal normally and can lead to infection and tissue death, necessitating amputation.
Diabetes is one of the leading causes of limb amputation. People with diabetes are 15 times more likely to undergo amputations than those without.
Amputation can lead to:
- Significant functional loss
- Decreased quality of life
- Socioeconomic impairment
Fortunately, an effective salvage program can prevent diabetes-related complications in the limb and the need for amputation. Therefore, limb salvage should be considered a first-line approach in treating patients with a diabetic limb.
Limb Salvage Programs
Employing a multidisciplinary approach has proven successful in diabetic limb salvage. There are 5 main ways your doctor can help prevent amputation and save your limb. These include:
Body or limb care:
- Have regular checkups of the limb
- Take good care of the feet and limb
- Regularly monitor the risk factors
- Control or maintain blood sugar levels
- Maintain a healthy weight and blood pressure
- Reduce stress, stop or reduce smoking
- Follow a well-balanced and healthy diet plan
- Maintain a consistent meal and snack schedule
- Stop or restrict overly sugary foods and drinks
- Massage of the affected limb
- Training or exercise regularly
- Use of medications such as insulin as recommended by your doctor
- Treatment of wound infections early
Limb salvaging surgery is a complex procedure that may involve tendon transfer and soft tissue or bone reconstruction.
There are two types of surgeries:
- Open surgery
- Minimally invasive surgery
Regardless of type, the surgery usually involves:
- Incision and drainage of an abscess or ulcer
- Debridement of infected tissue and bone to remove dead tissue
- Resection of bony structures that are causing skin breakdown
- Cutting out infected parts that block the blood supply
- Wound reconstruction using pedicles or flaps and skin grafts
The surgery can preserve limb function, allowing you to keep moving and doing the things you normally do. The doctor will discuss each option and choose the appropriate approach for the best outcome.
Benefits of Limb Salvage
Potential advantages of diabetic limb salvage program are:
- Prolongs productivity
- Promotes independence
- Improves quality of life (QOL)
After-Care and Recovery
Recovery from diabetic limb salvage surgery may take some time and you will need to stay off your feet or limb for a specific time as directed by your surgeon. You may also be required to adhere to a care plan to keep your limb healthy and reduce any risks of limb complications.
Diabetic limb salvage can be a complex and time-consuming process. There is no guarantee it is a permanent solution without a commitment to a healthier lifestyle.