For Patients

At the Amputation Prevention Center, we believe limb preservation begins with early intervention and customized patient education. Our unique team-based approach to amputation prevention involves patients as part of the care. Here you’ll find information, resources and tools to help you understand the risks, as well as your treatment options.

Risks Associated with Diabetes
Early Intervention and Prevention
Treatments and Procedures
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The majority of threatened limbs we treat and save belong to patients with diabetes. A chronic disease that impacts 24 million people in the U.S., diabetes results in a number of complications including impaired blood circulation, loss of nerve function, a weakened immune system, foot ulcers and infections — all of which can lead to lower extremity amputations.

Sixty to seventy percent of patients with diabetes suffer from neuropathy, a nerve dysfunction that causes serious numbness of the feet. This numbness can in turn lead to injury and non-healing wounds or ulcers on the feet that may become infected. In severe cases, the limb must be amputated to stop the spread of infection. Unfortunately, amputation of diabetic limbs is becoming increasingly common. But with the right treatment and expertise, amputation can also be avoidable.

• The amputation rate is 10 times higher in people with diabetes than those without diabetes.
• Every 30 seconds, someone with diabetes loses a limb.
• An estimated 85% of amputations are preventable.

At the Amputation Prevention Center, we specialize in reducing the rates of amputations for diabetic patients with threatened limbs.

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Up to 20% of patients with diabetes will develop an ulcer over their lifetime. If you have diabetes, it’s important to undergo a yearly foot examination. The American Diabetes Association also recommends an examination of the peripheral circulation every five years. At the Amputation Prevention Center, patients receive thorough examinations plus a range of additional intervention.

For diabetic patients who have not yet suffered foot complications, our specialists perform a series of risk assessment and diagnostic procedures, including:

• Identifying a patient’s risk for developing a foot ulcer over the next year.
• Using advanced tools to check for sensory loss in the feet, circulation in the extremities, and foot deformities or joint problems that may increase the risk of wounds.
• Consulting with neurologists, vascular specialists, endocrinologists and other specialists for diagnosis.
• Prescribing protective shoes and foot thermometers that monitor skin temperature to gauge the risk of ulcer development.
• Providing one-on-one education and individualized plans for ulcer prevention while minimizing the impact on the patient’s daily life.
• Offering in-house treatments, facilities and expertise when more serious problems do arise, placing the limb at risk.

For patients with diabetes who have threatened limbs, amputation isn’t the only answer. Through an integrated, team-based approach that combines the expertise of podiatric and vascular surgeons, we have achieved tremendous success in significantly reducing amputation rates and saving limbs.

We offer a range of advanced and effective treatments and procedures for limb salvage, using the latest technologies including:

• One of the region’s only hydroscalpels to debride infected tissue
• 3D wound cameras that capture accurate 3D images of wounds
• Special diagnostic camera that can see oxygen under the skin
• Laser Doppler to determine skin blood pressure
• Thermal imager to detect heat and inflammation
• Newly renovated OR and angiography suite equipped for reconstructive and vascular surgeries

Our specialists will work with you and your physician to identify the optimal treatment plan for you.

Charcot Foot Reconstruction

Charcot foot is a softening of the foot bones caused by severe neuropathy — numbness common in many diabetic patients. The ligaments can no longer support the foot, causing the bones to slip out of position, push against soft tissue, which then breaks down leading to ulcers. Unable to feel the pain, the patient is unaware of the trauma occurring and continues to walk on the injured foot, making the damage even worse.

In the past, amputation was often the end result of a Charcot Foot. At the Amputation Prevention Center, we specialize in Charcot Foot reconstructive surgical procedures, including external fixators that support the bones from the outside, preventing complications from screws and plates that may fail.

Revascularization

A complication of diabetes, peripheral arterial disease (PAD) or poor circulation can often lead to foot ulcers and non-healing wounds. For many diabetic patients with at-risk limbs, a combination of revascularization and reconstruction can save a limb that might otherwise require amputation. At the Amputation Prevention Center, ours is one of a handful of teams in the nation that combines the expertise of onsite vascular and podiatric surgeons who specialize in limb salvage.

For diabetic patients with at-risk limbs and impaired circulation, our Board-certified vascular surgeon offers extensive experience in revascularization via bypass or angioplasty to restore circulation to the foot. Allowing us to preserve and restore limbs, rather than amputate them.

Stem Cell Therapy

The regenerative power of stem cell therapy has shown promising results in saving at-risk limbs of diabetic patients. At the Amputation Prevention Center, we are leading the exploration of regenerative medicine as an alternative to amputation. Our doctors have performed award-winning research using adult marrow derived from stem cells for chronic wounds.

Negative Pressure Wound Therapy

We use Vacuum Assisted Closure (V.A.C) negative pressure wound therapy to promote wound healing through enhancement of the wound tissue. Clinically proven to accelerate the healing of non-responsive wounds, V.A.C. therapy works by applying a vacuum at the wound site, drawing wound edges together, removing infectious materials and promoting faster tissue regeneration and healing at the cellular level. V.A.C. therapy is often combined with other treatments for best results.

Bioengineered Skin Tissue Grafts

Bioengineered skin tissue grafts have demonstrated excellent results in promoting faster and more complete healing of chronic and hard-to-heal wounds. In this type of procedure, our podiatric surgeons apply the tissue graft to the wound, then carefully monitor the wound’s progress to ensure it heals properly — and stays healed.

Foot-Sparing Amputations

In severe cases where amputation is necessary in order to prevent the spread of infection, our podiatric surgeons concentrate on preserving as much as of the foot and foot function as possible. Advances in limb-sparing surgical techniques, partial amputation and prosthetic technologies have allowed many patients to regain much of their mobility.

Advanced Techniques for Wound Closure

Wound closure is critical to wound healing, and to preventing the likelihood of infections returning. Our team of surgical wound care specialists excel in a range of plastic surgical techniques to achieve wound closure, including skin flaps, skin grafting, and mechanically assisted wound closure using skin-stretching devices. Our priority is to obtain wound closure thus preventing infections.

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If you are a patient with diabetes, you may be at risk for complications that put your limbs at risk. Take the first step to preserving your limb function and your quality of life. Ask your physician to refer you to the Amputation Prevention Center at Valley Presbyterian Hospital today.

Contact us for more information.

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