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Limb salvage specialists give new hope for an end to amputations

"The days of Australians having to get their limbs amputated because of diabetes are nearly over," a chronic wound specialist told this reporter recently.

 

How can that be when there are still 4,400 diabetes-related amputations performed in Australia every year?

 

Because there has been a quiet revolution in vascular surgery in Australia.

 

A technique used by Associate Professor Ramon Varcoe at the Prince of Wales hospital in Sydney has more than halved the rate of major amputations in people his team were treating during an eight-year reporting period.

 

The results were reported in the Journal of Endovascular Therapy in 2015.

 

The technique, known as endovascular revascularisation, involves inflating collapsed arteries with tiny balloons and then inserting a stent to help keep the arteries open.

This improves blood flow and gives the limb a much better chance of survival.

 

"If you're told that you need to have a limb amputated, get a second opinion," Dr Varcoe said in an interview with Circle magazine earlier this year.

 

Research has shown that up to 85 per cent of amputations are preventable if problems are detected and treated early.

 

The message is clear: If you feel numbness in your limbs, do not ignore it. Early intervention combined with new surgery techniques are giving people with diabetes their best chances of avoiding amputations.

 

Dr Varcoe's treatment is used in cases where amputation is the only option.

 

"Often we can perform surgery as a day procedure and there has been a  massive reduction in major amputations as a result," he said.

 

"We looked at the experience here at the Prince of Wales Hospital over an eight year period and we were amazed to see that we had reduced the number of major amputations by more than 60 per cent.

 

"This reflects what we are seeing in everyday practice and what we are observing on the ward."

 

Dr Varcoe is confident that diabetes-related amputations will be eliminated within a generation.

 

"At the moment, patients need more education, they need to understand the importance of prevention and they need to know about the avenues towards seeking care with specialists who have a particular interest in limb salvage," he said.

 

"The cornerstone of eliminating diabetes-related amputations is that prevention is much better than cure. However, once you have a serious foot infection you need a limb salvage specialist." 

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