Risk Factors for Lower Extremity Amputation

Diabetic ulcers are the most common foot injuries leading to the possibility of lower extremity amputation. Physicians play an important part in the prevention and early diagnosis of diabetic foot complications. In order to manage the diabetic foot, it requires knowledge of the risk factors for amputation. The patient must have a routine evaluation and preventive maintenance. The most common risk factors for ulcer formation include diabetic neuropathy (a family of nerve disorders caused by diabetes), structural foot deformity and peripheral arterial occlusive disease (impaired circulation to the extremities). Patient education regarding foot hygiene, nail care and proper footwear is crucial to reducing the risk of an injury that can lead to ulcer formation. This approach may ultimately lead to a reduction in lower extremity amputations related to diabetes. 

                            Common risk factors for amputation of the diabetic foot
                          include peripheral neuropathy, and structural foot deformity.

* Absence of protective sensation due to peripheral neuropathy

* Arterial insufficiency

* Foot deformity and callus formation resulting in focal areas of high pressure

* Limited joint mobility

* Obesity

* Impaired vision

* Poor glucose control leading to impaired wound healing ulceration,
 infection and peripheral vascular disease.

* History of foot ulcer or lower extremity amputation 
                            
                                                                                               
                                                      
                                                        Bedsores or Decubitus Ulcers

          Bedsores (pressure ulcers), also known as pressure sores or decubitus ulcers, result from prolonged pressure that cuts off the blood and oxygen supply to the skin, causing the skin and other tissue to die. The damage may occur in as little time as 12 hours of pressure, but it might not be noticed until days later when the skin begins to break down. The skin is especially likely to develop pressure sores if it is exposed to rubbing (friction) and moving the skin in one direction and the body in another, as in sliding down when the bed head is raised. Dampness (such as from perspiration or incontinence) makes the skin even more susceptible to developing pressure sores. Treatment of these types of problems is what we specialize in. We work with new techniques as well as Hyperbaric Oxygen Treatments. Below are pictures of treatment with Hyperbaric Oxygen as an adjunct to our normal care. The North Florida Amputation Center specializes in modern techniques and oxygen therapy through the use of hyperbaric oxygen chambers. These oxygen chambers infuse the body with 100% oxygen resulting in dramatic improvement in wound recovery resulting in fewer amputations due to the inability of the body to heal itself. 

Below is a wound treated with HBOT and after 30 treatments it is almost closed. the doctor

will evaluate.

HBOT has a long history of use for various medical conditions especially wound care, but can be applied to other maladies including burn injuries, migraine headaches, rheumatoid arthritis and stroke rehabilitation to name a few. Medicare currently covers oxygen therapy for 14 different medical conditions