Lower-limb amputations are a relatively common complication associated with severe or poorly-controlled diabetes. If an amputation is on the horizon, knowing what to expect and how to care for yourself after the procedure will reduce your risk of complications.
Reasons For Amputations
If you are scheduled for an amputation, it is because you have a wound that has not healed and has caused the tissue to die and may have spread to the bone. With diabetics, even benign injuries to the feet or legs can turn into life-threatening infections for several reasons. In some cases, nerve damage might prevent a diabetic from realizing an injury exists and how wide-spread the damage is before they seek help. Even with prompt medical care, the risk of infection and peripheral artery disease is high. When the peripheral arteries are damaged, blood flow is significantly reduced, which can cause or exacerbate tissue necrosis.
What To Expect
Amputations are varied and although your vascular surgeon may have a plan for the amount of tissue and bone they will remove, it is important to remember your amputation could be more extensive than originally planned. They will inform you of this uncertainty when they explain the surgery to you. Some people may expect to have a toe removed, only to wake up with more toes or an entire foot gone. This is because it may be impossible to determine the extent of damaged tissue until the surgeon can look inside. Due to the rapid spread of infection and necrotic tissue, it is important to find healthy tissue, which can mean more tissue needs to be removed. Otherwise, the infection will continue to spread and more tissue will die, which will result in another surgery.
Important Post-Operative Issues
Having an amputation as a diabetic presents unique challenges. The increased risk of infection and poor healing may have precipitated the amputation, but these same risks can complicate healing after surgery. It is important to follow post-operative guidelines meticulously. Whenever possible, seek out resources for help before you have surgery. People who are uninsured, immobile, live alone, or have other hurdles, should speak with their surgeon for advice. You may need help coordinating in-home wound care or transportation to the hospital for intravenous antibiotics. Other specialists may have suggestions for better control of your blood glucose, in hopes of avoiding additional amputations.
Amputations are an unfortunate consequence of damage related to diabetes. Although the thought of losing a limb can be life-altering, such a drastic surgery can be life-saving.