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Is Amputation The Only Treatment For Diabetic Foot?

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Posted on Thu, 2 Apr 2015
Question: My father is 73 years old, diabetic for 30 years and had his bypass 13 years back. He has a diabetic foot that couldn't be cured and the plastic surgeon advises amputation below knee to avoid getting septicemia. He is not mentally prepared for amputation. Moreover his other organs have also weakened during repeated hospitalization, mainly the heart with EF at 32% and of late he has got fluid accumulation all over his body oozing through his legs and is unable to breathe properly. We are not sure amputation to avoid septicemia can give him better quality life or make him more bed ridden. Grateful if you can give some guidance.
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Answered by Dr. Dr. Naveen Kumar Sharma (1 hour later)
Brief Answer:
Amputation should be done without hesitation

Detailed Answer:
Hello,
I have studied your case and I can understand your condition. Amputation is always last choice for doctors. But it is a very good surgery. So if your dad is having septicemia, you should get amputtion of the leg as early as possible.
His general condition will also improve and sugar level and breathing will be normal with in two days of surgery.
So do not delay this as it can be life threatening to keep infected wound. Go ahead with amputaion and i can assure you that he will be walking with an artifical limb with in two to three months.
I hope this answer will be helpful for you.Let me know if there is any other followup questions.
thanks
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Dr. Naveen Kumar Sharma (24 minutes later)
Sir,

Thank you for your suggestion. It's still not infected and he hasn't got septicemia yet. If it was just about the leg, we would have got it amputated by now. His wounds in the last one year haven't healed well due to his high sugar levels in spite of strict diet and insulin thrice a day. He has had kidney issues causing lack of urination often during his treatment for foot. Doctor says he can't be given pain killers and strong antibiotics due to his kidney and heart condition. His pulse dropped to alarming levels last few times while in OT for dressing on mild sedation.

Our concern is we don't want it to get worse after amputation. He has been a very active person until 2 months back but now he is bed ridden, panting and not even able to talk a few words. Would you still recommend amputation?

Is there an option to prevent septicemia keeping the leg intact through a bypass or other means?
doctor
Answered by Dr. Dr. Naveen Kumar Sharma (8 hours later)
Brief Answer:
His condition is worsening becuase of delay in amputation

Detailed Answer:
Hello,
After studying your father's symptoms I think he is in septicemia. Infection is there is leg and it is not allowing sugar to become normal. Also Panting and not able to speak all these symptoms are because toxins are going in blood through leg.
Keeping his leg attached with body will not serve any purpose and only cause more harm.
So I would suggest you to plan amputation as soon as possible. I can assure you that he will improve with in two to three days of ampution.
thanks
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Naveen Kumar Sharma

Orthopaedic Surgeon, Joint Replacement

Practicing since :2002

Answered : 4486 Questions

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Is Amputation The Only Treatment For Diabetic Foot?

Brief Answer: Amputation should be done without hesitation Detailed Answer: Hello, I have studied your case and I can understand your condition. Amputation is always last choice for doctors. But it is a very good surgery. So if your dad is having septicemia, you should get amputtion of the leg as early as possible. His general condition will also improve and sugar level and breathing will be normal with in two days of surgery. So do not delay this as it can be life threatening to keep infected wound. Go ahead with amputaion and i can assure you that he will be walking with an artifical limb with in two to three months. I hope this answer will be helpful for you.Let me know if there is any other followup questions. thanks