Jaisalmer (Rajasthan) [India]: Awareness about vascular diseases is significantly low and ergo many limbs are lost to amputation. Trauma, vascular diseases, infections, and tumors are among the primary causes that lead to this grave outcome
India is the diabetic capital of the world and it is estimated that there are 101 million diabetics in India out of which 6-7 % of them develop vascular complications.
80-85% of amputations are preceded by a leg ulcer, and timely diagnosis and the right intervention can have a favorable outcome.
It is crucial to make people aware of the statistics on amputation so they can take active steps to prevent it. According to the World Health Organization, patients with diabetes are 10 times more likely to have a lower limb amputation than a person without diabetes. It is of utmost importance now more than ever to impart awareness for an amputation-free nation.
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Peripheral artery disease (PAD) – Lower limb amputations often stem from complications related to vascular diseases, particularly peripheral artery disease (PAD) and diabetes. Age, Diabetes, and smoking are the three most important contributing factors. Reduced blood flow to the lower extremities can lead to non-healing wounds, ulcers, and infections, making amputation a necessary intervention. Non-healing ulcers, infections, and gangrene are more common in diabetic patients. Diabetes, especially in its advanced stages, can lead to severe complications, including peripheral neuropathy and vascular complications. When these conditions become unmanageable, amputation may be the last resort to prevent the spread of disease and protect the individual’s overall health.
Patients with diabetes and PAD are at a higher risk for amputation because the symptoms of these diseases can quickly get worse and lead to end-stage PAD, known as Critical Limb Ischemia.
Critical limb ischemia – is a condition with blockage in the blood vessels of the leg that threatens the blood supply to the limb and thus the life of the limb, putting the patient at risk for amputation. Patients typically notice that their legs have a bluish color and are shinier than usual. This changed appearance is because the legs and feet are not receiving healthy blood flow due to blocked arteries. Patients with Critical Limb Ischemia may experience leg pain even at rest.
Gangrene – Reduced blood flow and poor circulation can cause gangrene in the legs and feet of many patients. Gangrene occurs when a body part does not have enough oxygen-rich blood and the healthy tissue begins to die. Patients with diabetes and PAD who have noticed symptoms of gangrene should seek medical treatment immediately because gangrene can quickly lead to amputation.
Amputation can be avoided using either arterial bypass surgery or angioplasty with stents. These surgical or endovascular interventions can restore blood circulation and prevent major amputations either below or above the knee.
With awareness and quick intervention, an amputation-free world is not just possible but achievable.
By Dr Manvendu Jha, Dr Srishti Walia
Consultant vascular surgeon – Government of India, Defence services
All India Toll-Free Vascular Information Number – 18002035156
