The number of leg amputations varies greatly from country to country, but our country has one of the highest intervention rates in the European Union. Leg amputations can be performed according to frequency due to vascular disease and diabetes, trauma, tumor, inflammation, limb developmental disorders and other reasons. Vascular diseases are responsible for more than 80% of leg amputations. Dr. Évat Kósawe asked the angiologist of the Thrombosis and Hematology Center about the treatment of vascular diseases and the prevention of leg amputation.
Hungary has one of the highest rates of leg amputations in the EU
In Hungary, leg amputations are performed in 42 cases out of 100,000 people every year. In comparison, in Sweden the number is between 20-35 per 100,000 inhabitants per year. The rate is even higher in the elderly, men, diabetics, smokers, and patients with arteriosclerosis. It is known that foot amputation in diabetic patients can be up to 15 times more common than in non-diabetic patients. In diabetes, the situation is also complicated by the fact that without the presence of peripheral coronary artery disease, the so-called limb loss can also occur due to diabetic foot syndrome.
Diabetic foot syndrome can be caused by circulatory disorders, bone and joint abnormalities, and nerve damage (neuropathy), and as a result, even an infection from a banal wound can develop in a short time.it can also lead to the loss of a toe or a limb. There is a consensus that unnecessary leg amputations due to diabetes can be greatly reduced by screening, educating patients, treating the disease appropriately, and providing adequate attention to patients.
Arteriosclerosis screening – when is it justified?
The occurrence of vasoconstriction is more common during certain conditions and diseases, so regular screening is recommended when these conditions exist, even if there are no symptoms. Such a condition is, for example, old age, high blood pressure, diabetes, smoking, high cholesterol, after some type of cardiovascular disease (mainly stroke, heart attack), as well as if there is a family history of arteriosclerosis. It is a particularly high risk if several of the above are present at the same time. In the case of typical symptoms of vasoconstriction, it is always important to consult a doctor.
Symptoms and signs of lower extremity vasoconstriction:
- cool, pale limb or lividity, skin redness
- split nails, nail fungus, missing fur
- Pain or numbness in the lower leg, thigh, or buttocks area when walking, which subsides when you stop (“shop window disease”)
- serious symptoms: wound, ulcer, blackening on toes and heels
Peripheral coronary artery disease is confirmed by determining the ankle-brachial index. The test consists of blood pressure measurements on the arms and legs. The severity of the disease can be determined based on the index and clinical symptoms. Serious wounds, ulcers, and tissue death that cause pain even at rest are a risk of amputation exists in case of When these symptoms are present, the circulation of the limb is critically low.
In case of these symptoms, the examination by a specialist cannot be postponed. Unfortunately, very often the patients do not even report these complaints to their family doctor, and at home, treating their already swollen, blackened toes with various creams, they await recovery. Delay can cause irreparable damage and even lead to the loss of a limb.
Initially, it does not cause any symptoms
Dr. Éva Kósa according to the angiologist of the Thrombosis and Hematology Center, to reduce the number of amputations, several paths must be taken. It is of prime importance early recognition and treatment of known risk factors – this means long-term prevention. The number of amputations can be reduced in the medium term with screening and appropriate treatment of vasoconstriction.
In the case of severe vasoconstriction symptoms and diabetic leg ulcers, it is important to consult a doctor early and receive professional medical treatment – then the existing danger of amputation can be averted. Avoiding amputations is not only an individual, family, but it is also of outstanding significance and importance at the level of society as a whole.
Source: Thrombosis and Hematology Center
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