THIRUVANANTHAPURAM: If you thought amputations are recommended as a last resort to save an infected leg, you are in for a shock. Around 20 to 25 amputations, of either leg, are done in Kerala every day, says the Vascular Society of Kerala (VASK). That’s one almost every hour. An analysis by VASK also found that half of the amputees either lose the other leg or die of heart diseases in the next two years.
What’s appalling is that around 80% of leg amputations are completely unnecessary, as new treatments methods are available in select centres for salvaging the affected limb. Surgeons perform amputations to remove a patient’s leg that was infected due to diseases that restricted blood flow to the limbs or following a serious injury. According to VASK, most of the amputees are aged between 40 and 50.
“The decision to amputate a leg may seem practical. The patient and bystanders think it is a permanent cure and they will be able to save the money required for treatment. This is not true,” said Dr R C Sreekumar, VASK founder secretary and associate professor of vascular and thoracic surgery at the Thiruvananthapuram Medical College Hospital. High prevalence of diabetes and smoking are considered major reasons for restricted blood flow to legs and infection. High blood pressure and cholesterol may also cause it.
Salvaging of limbs cost-effective, good for patients
New studies and treatment methods show that in most cases, the damaged legs can be salvaged. Besides being good for the mental and physical well-being of a patient, salvaging is also cost-effective. Still, patients often hastily opt for amputation due to ignorance and constant prodding by bystanders and some doctors, said health experts.
A post-amputation analysis by VASK found that 50% patients who got amputated above the knee either died of heart diseases or had to amputate the other leg in the next two years, Dr Sreekumar said.“The life of amputees also gets compromised due to lack of social support. Only 20% of amputees manage to get socialised. Most get others’ support for two weeks. After that they are on their own. Many do not turn up for post-amputation review,” he said.
Dr Remla Beevi, who retired as the Director of Medical Education recently, said new limb salvage procedures are expected to reduce the number of amputations. “Most of the amputations are due to diabetic foot. Efforts are on to develop podiatry or foot care as a specialty to help patients save their limbs,” she said.
VASK has launched the campaign ‘Save a limb, save a life’ and started a toll-free number 18001237856 to help patients salvage their legs and, in the process, their life. The helpline connects patients to top vascular surgeons. Over 200 calls have been received since the number’s launch on August 6.
Salvage treatments involve ensuring blood flow to the brain and treating the infections. The treatment costs Rs 1-2 lakh. Getting a good prosthetic leg and support system would cost around Rs 3-4 lakh. While one can get prosthetics supplied by the government for free or get one for Rs 50,000, doctors say prosthetics that ensure flexibility cost much higher.
- 50% amputees either die or lose other leg in 2 years
- 80% amputations avoidable with salvage treatment
- Red flags
- Pain during walking
- Wounds remain unhealed for 2-3 weeks