Amputation Avoidance
What is Amputation Avoidance?
Hyperbaric oxygen therapy in many cases can open the door to options to save a limb from amputation.
It can be a “best friend” to support vascular and orthopaedic surgeons in difficult cases.
Progress has been made in recent years to defer and often avoid the permanent loss of a lower limb by surgical amputation.
Vascular surgeons are able to open smaller and more distant vessels to re-supply vital blood flow to the foot. Hyperbaric oxygen can be used to assist - and achieve better outcomes.
It can revitalize and guide the path to recovery of such compromised tissue.
If an injury does not heal with standard wound care, other therapeutic interventions are offered, one of which is HBOT.
Why diabetics?
The majority of our patients are diabetics suffering from the complications of this disease. People with diabetes are especially susceptible to lower limb and foot wounds that do not heal. They have seen amazing healing results, driven by hyperbaric oxygen therapy (HBOT) permitting improved quality of life.
It is estimated that about 15% to 25% of people with diabetes develop a foot ulcer in their lifetime. These wounds are often resistant to treatment and difficult to heal; therefore, people with diabetes experience lower limb amputation at about 20 times the rate of people without diabetes.
People with diabetes may experience:
- Nerve damage, which can lead to weakness and numbness in the foot that predispose patients to foot injuries, either through trauma or by continuing to walk on a severe blister or callus without feeling any pain.
- Very dry skin that is prone to cracking, increasing the risk for infection.
- Peripheral artery disease, which can cause a hardening and obstruction of blood vessels in the lower leg and foot. This condition results in poor circulation, which can make fighting infection more difficult and make patients more susceptible to ulcers.
- Other factors that may contribute to complications with wound healing include poor tissue perfusion (spread of oxygen in the body), bacterial infection, malnutrition, and poor control of blood glucose levels.
Opportunity
Hyperbaric oxygen therapy in many cases can open the door to options to save a limb from amputation.
Progress has been made in recent years to defer and often avoid the permanent loss of a lower limb by surgical amputation. Vascular surgeons are able to open smaller and more distant vessels to re-supply vital blood flow to the foot. Hyperbaric oxygen can be used to assist and achieve better outcomes. It can revitalize and guide the path to recovery of such compromised tissue.
Sadly, in the majority of these cases patients have diabetes which almost set them up for failure by suppressing their immune system (so they have poor infection fighting capacity) and disguising the problem by blunting the sensory nerves so that no injury is perceived. In addition, persons with diabetes develop vascular blockages much more quickly than the average population and require the skills and vascular surgeons to improve arterial supply.
Hyperbaric oxygen therapy (HBOT), on the other hand, is almost a “magic bullet” drug for persons with diabetes because it helps the body’s defences to kill bacteria along with recruiting repair cells to the area of concern to hasten repair of damaged tissue.
In a review published online in May of 2017 Ontario Health Quality conducted an assessment of the safety, clinical effectiveness, and cost-effectiveness of standard wound care plus HBOT versus standard wound care alone for the treatment of diabetic foot ulcers.
