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What is an Amputation Prevention Center®

The Amputation Prevention Center is a center of excellence dedicated to preventing lower limb loss in those patients with chronic wounds who may be facing lower limb amputation.

We bring together a unique and highly effective collaborative approach to limb preservation, offering advanced services with a dedicated, surgically trained staff. Our approach to healing is aggressive and comprehensive, coordinating traditional and advanced therapies, with a focus on surgery to heal wounds and improve circulation.

For patients with threatened limbs resulting from a chronic wound, there may be alternatives to amputation.

Great Day Houston - Amputation Segment

 

When should I call the Amputation Prevention Center?

Time is of the essence when trying to save a limb. Any time you have a sore or wound on your lower extremity that concerns you, talk to your physician or contact the Amputation Prevention Center for an evaluation.

Call for an appointment right away if you experience any of the following symptoms:

  • If you have a foot or leg ulcer that is red and/or swollen
  • If you have an ulcer or skin surrounding an ulcer that has turned black
  • If you have a fever or flu-like symptoms with any redness, swelling or ulcer
  • If you develop a leg or foot ulcer and you have had a previous major or minor lower limb amputation
  • If you have been told you might need an amputation of a toe, foot, or lower leg

Phone 713-867-2672 Fax: 832-747-1006

What is a chronic wound?

A wound or ulcer that fails to respond to treatment after four weeks or has not healed entirely in two months is considered to be a chronic wound. Chronic, non-healing wounds can have serious health consequences and may adversely affect your quality of life.

Often complicated by underlying conditions, what seems like a simple wound on your foot or lower leg can turn into a significant problem. There are many factors that can cause a wound to become chronic enough to lead to amputation, however the majority of lower limb amputations are due to foot ulcers that are a result of complications from diabetes, including:

  • Neuropathy
  • Poor circulation
  • Charcot foot
  • Gangrene
  • Infections

How does a chronic wound lead to amputation?

Lower extremity amputation is an unfortunate and often avoidable complication of diabetes. Many people with diabetes develop neuropathy or peripheral arterial disease, which can contribute to chronic wounds.

If you are suffering from neuropathy, you may be unable to feel, or have reduced feeling in your feet. An injury or repetitive trauma like a blister from a tight shoe can go unnoticed and cause a sore or ulcer to form.

Also, if you have diabetes, you have an increased risk of developing peripheral arterial disease, or a narrowing of your arteries in various parts of your body, especially your legs. This in turn may cause poor blood flow to your feet. Skin with reduced blood flow does not heal as well as normal skin and is more likely to get damaged. Therefore, if you develop a sore, it may take longer to heal or turn into an ulcer.

Ulcers develop in up to 25% of those with diabetes over their lifetime. The longer an ulcer remains open and unhealed, the more likely it is to become infected. Foot ulcers complicated by infection are often what leads to an amputation.

How can the Amputation Prevention Center help?

An Amputation Prevention Center provides care to those suffering from chronic wounds, infections, gangrene, and other conditions of of their lower extremities in a way no other provider can. We utilize an innovative team-based approach that pairs foot and ankle surgeons with vascular specialists – with significant results in reducing major amputations.

And, since many patients require admission to the hospital for surgical intervention, you will be assigned a case manager focused on coordinating your care through the inpatient-outpatient process.

Advanced therapies, including hyperbaric oxygen therapy

The Amputation Prevention Center brings together a unique and highly effective collaborative approach to limb preservation, offering specialized services, including:

  • Infection control
  • Restoration of blood flow
  • Sharp debridement (removal of dead tissue)
  • Foot reconstruction
  • Skin grafting
  • Hyperbaric oxygen therapy
  • Wound closure
  • Cutting-edge diagnostics
  • Bioengineered skin substitutes

What is hyperbaric oxygen therapy?

Hyperbaric oxygen (HBO) therapy is a treatment in which the patient breathes 100% pure oxygen while inside a pressurized chamber. The air pressure inside a hyperbaric oxygen chamber is about two and a half times greater than the normal pressure in the atmosphere. This “hyperbaric” (or high pressure) dose of oxygen helps your blood carry more oxygen to your organs and connective tissues to promote wound healing. It also activates the white blood cells to fight infection.

HBO can be the primary treatment or it can be used in combination with other treatments. HBO therapy is an outpatient procedure that is provided once daily, for approximately four to six weeks. One treatment takes about two hours and is quite comfortable for most patients.

Hyperbaric oxygen therapy is approved to treat the following conditions:

  • Non-healing wounds, such as diabetic foot ulcers
  • Chronic bone infection (chronic refractory osteomyelitis)
  • Injury to skin or bone as a side effect from radiation therapy
  • Non-healing skin grafts and flaps
  • Crush injuries
  • Bubbles of air or gas in your blood (embolism)
  • Carbon monoxide poisoning
  • Sudden hearing or vision loss

Multidisciplinary panel

Our center is staffed by a team of experienced specialists, with advanced training in limb preservation techniques. They will customize the most effective treatment plan to stimulate healing, allowing you to recover as quickly and completely as possible. Integrating a team of specialists increases the level of care, while offering you the most advanced healing options.

Since the majority of patients seen in our center have diabetic foot ulcers, the team is designed around the needs of those patients. Which is why our center provides access to the specialists and consultants needed throughout your healing process, including:

  • Podiatrist
  • Vascular surgeon
  • Plastic surgeon
  • Hyperbaric specialist
  • Diabetes Educator
  • Nephrologist
  • Cardiologist

What can a patient expect?

Your course of treatment depends on what type of wound you have. During your first visit, our staff will evaluate your wound and review your medical history. You may also need special tests that give us information about circulation to the wound. This will then help to determine what course of treatment you will need.

Our treatment plans are designed to complement the care your own physician provides, ensuring that your health care team is always working together to provide the treatment that’s right for you. Most treatments are covered by Medicare/Medicaid, HMOs and other private insurance plans.

Some things you can do to assist with your healing:

  • Care for your wound at home as directed by your healthcare provider
  • Eat a healthy diet
  • Rest according to your healthcare provider’s instructions
  • Take medication as ordered
  • Stop smoking
  • Return for your follow up appointments

Once a treatment plan has been prescribed, you will visit the Amputation Prevention Center on a regular basis for specialized treatments and documentation of your healing progress. Keeping appointments and following directions are critical to attaining a positive healing outcome.

Commitment to and following your plan of care is the single most important factor in your healing.

How to prepare for hyperbaric oxygen therapy (HBO):

Treatments normally last about two hours. A staff member will tell you how many treatments you will need. During your treatment, you may watch television, a movie or take a nap.

You will be given a 100% cotton clothing to wear in the chamber. No cosmetics, perfumes, hair preparations, deodorants, wigs, jewelry or electronic devices are allowed in the chamber (most pacemakers are allowed in the chamber). The hyperbaric technologist will need to know if you are taking any medications, including non-prescription drugs. You are advised not to drink alcohol or carbonated beverages for four hours prior to treatment.

Smoking and the use of tobacco products interferes with the body’s ability to transport oxygen. Therefore, your doctor will work with you on techniques to help stop smoking during the treatment period.

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