Amputation prevention

April is amputation prevention awareness month. Amputation rates are increasing in The Bahamas, the Caribbean and worldwide. In the United States, 160,000 people with diabetes undergo lower extremity amputations each year. It is unknown the exact number of amputations that are performed in The Bahamas each year.

A small study revealed 45.9% of all diabetics admitted had lower extremity complications including cellulitis (20.6%), peripheral arterial disease (20.3%), foot infection/abscess (18.6%), foot wounds (13.1%), bone infection (osteomyelitis) (4%) and Charcot Foot (1.3%). About 24.8% of diabetics admitted to hospital had surgery. Below knee amputation (BKA) was the most common surgery performed (35%) followed by toe amputation (21%).

Amputations are one of the most common, most expensive and dreaded complications of diabetes — 80% of non-traumatic lower limb amputations happen due to diabetes complications. An individual who had an amputation has a higher chance of dying in five-years than someone with coronary artery disease, breast, and prostate cancer.

Every 20 seconds, a lower extremity amputation occurs due to diabetes. In the United States, every three minutes and 30 seconds, a limb is amputated due to diabetes. These amputations are more prevalent among people of color. Quite simply, whether-or-not you have a limb amputated can come down to the color of your skin, how much money you make, and where you live. Most, or 85% of all amputations happen in people who had a foot ulcer and can be prevented if the ulcer is prevented or heals.

Amputation is surgical removal of part of the body that is no longer healthy or functional and puts the health of the body at risk for future complications.

Minor amputation: An amputation of a smaller part of the foot, including a part of a toe, an entire toe, or a portion of the foot that involves the toes.

Major amputation: An amputation that removes a part of the leg, including the foot, ankle, and lower leg and that may extend from removal of the thigh, above-knee amputation, or from below the knee.

The best way to prevent complications of diabetes, including foot ulcers, is to manage your diabetes. This includes eating a healthy diet, exercising regularly, checking your blood sugar regularly and taking your medicine correctly.

Taking care of your feet will help prevent problems. It can also ensure you get medical care as quickly as possible when you see problems. Proper foot care includes the following:

Look at your feet daily: Check your feet once a day for blisters, cuts, cracks, sores, redness, tenderness or swelling. If you have trouble reaching your feet, use a hand mirror to see the bottoms of your feet. Put the mirror on the floor if you can’t hold it, or ask someone to help you.

Wash your feet daily: Wash your feet in lukewarm (not hot) water once a day. Dry them gently, especially between the toes. Use a pumice stone to gently rub the skin where calluses easily form. Use a moisturizing cream or lotion on the tops and bottoms of your feet to keep the skin soft. Preventing cracks in dry skin helps keep bacteria from getting in.

Don’t remove calluses or other foot lesions yourself: To avoid hurting your skin, don’t use a nail file, nail clipper or scissors on calluses, corns or warts. Don’t use chemical wart removers. See your provider or foot specialist (podiatrist) to remove any of these issues.

Cut your toenails carefully: Cut your nails straight across. Carefully file sharp ends with an emery board. Ask someone for help if you can’t trim your nails yourself.

Don’t go barefoot: To keep from hurting your feet, don’t go barefoot, not even around your house.

Wear clean, dry socks: Wear socks made of material that pulls sweat away from your skin. This includes cotton and special acrylic fibers, not nylon. Don’t wear socks with tight elastic bands. These bands reduce circulation. Avoid socks with seams that could irritate your skin.

Buy shoes that fit correctly: Buy comfortable shoes that provide support and cushioning for the heel, arch and ball of the foot. Avoid tight-fitting shoes and high heels or narrow shoes that crowd your toes. If one foot is bigger than the other, buy shoes in the larger size. Your provider may recommend specially designed shoes (orthopedic shoes). These shoes fit the exact shape of your feet, cushion your feet and make sure your weight is the same on both feet.

Don’t smoke: Smoking makes it harder for your blood to go through your body. It also reduces the amount of oxygen in your blood. These problems can make wounds worse and slow down healing. Talk to your provider if you need help quitting smoking.

Schedule regular foot checkups: Your podiatrist will look at your feet for signs of nerve damage, poor circulation or other foot problems. Have a foot exam at least once a year or more often if recommended, or if you have an ulcer or other foot problem.

Limb preservation: You and your podiatrist should do all you can to prevent amputation. This may include exploring options for limb preservation, such as revascularization to increase blood flow to the foot and aggressive wound care to promote wound healing.

• For more information email info@familyfootcentre.com or visit www.foothealthfacts.org or www.footlogix.com. To see a podiatrist visit Family Foot Centre on #45 Daffodil Avenue, Independence Highway or call 605-3668; Bahamas Surgical Associates Centre at Hill Top Medical, telephone 603-1814/5. In Grand Bahama visit Lucayan Medical Center on East Sunrise Highway or call 373-7400.