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Abdominal surgery due to pain, am chain smoker and diabetic, wounds not healing due to varicose veins, fat reduction in leg. Medication?

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Vascular Surgeon
Practicing since : 2005
Answered : 8 Questions
I am 70 year old man and was a chain smoker till a month back.Because of severe pain I had a surgery last month( operated a nerve near abdomen for more blood circulation in the left leg) doctor advised there may be only 20% or 40% improvement in blood circulation, b'coz of smoking, the main 3 Arteries are damaged very badly, now wounds are not healing due to vericause and I am a diabetes patient too. from last few days I have noticed the left leg has become very thinn (only Skelton & Skin) the other leg is fat.With stretches I walk around just 15-25 steps in every half an hour more than that it is not possible.kindly suggest any other medication or surgery if possible.
Posted Tue, 17 Jul 2012 in Stroke
Answered by Dr. Srujal Shah 14 hours later
From your history it is very clear that you have atherosclerosis in your blood vessels worsened by smoking and diabetes.
The reason for thin leg and non healing wounds is also less blood supply.
I am a vascular surgeon and we daily see and treat such patients.
There are a few suggestions for you....
1.Check your sugars and bring them in control.
2. Get your legs examined by a vascular surgeon .you may also get an arterial doppler scan for your leg vessels. There can be a tight lesion stopping blood flow and can be corrected by angioplasty.
3. You can take blood thinning drugs like aspirin and clopidogrel. They will keep small vessels open.
4. A drug called cilostazole will definitely help you in healing provided your heart function is good. So just get a cardiologists opinion before starting it. it helps in 7 different ways.
5. If you have varicose veins also then keep your legs elevated with pressure bandage. it will help in healing.
6. If everything fails then as a last resort injection prostaglandin E 500 micrograms over 5 days can be given for non reconstructable vessels in a critical limb.
Best would be to XXXXXXX your vascular surgeon.
I hope i have replied your query till satisfied.
Get well soon XXXXXXX. Please let me know if you have any queries. I will be glad to help you.

dr srujal shah
vascular and endovascular surgeon.

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