Vascular health and limb preservation

Vascular Health and Limb Preservation

More than 1.5 million Americans are living without an arm or leg. A small percentage of these lost a limb because of cancer, and about 45 percent because of an accident.

But most limbs, about 54 percent, are lost because of peripheral vascular disease, most often due to complications of diabetes.

“This is a great concern because unless something is done to address the soaring rates of diabetes, the number of amputations in the U.S. is likely to soar as well,” says Dr. Niten Singh, a UW Medicine vascular surgeon at Harborview Medical Center and an expert in limb preservation.

In fact, some studies project that the number of Americans with amputations will double to more than 3 million by 2050, largely because of the increased number of people with diabetes.

“To address this growing problem, UW Medicine has put together a team of experts to promote vascular health, improve foot care and reduce the risk of amputation,” says Singh.

Some lifestyle changes can prevent vascular disease
The key to preventing peripheral vascular disease is to eat a healthy diet, keep physically active, maintain a healthy weight and not smoke.

It’s also important to have your blood pressure and blood sugars checked, and if they’re elevated, work with your doctor to bring them down. Often lifestyle changes can help and there are also many effective treatments.

Why foot care is important if you have diabetes
“In addition to taking steps to reduce their risk of atherosclerosis — or ‘hardening of the arteries’ — people with diabetes also have to take extra care of their feet,” says Singh.

That’s because in addition to poor circulation, people with diabetes often have nerve damage, called diabetic neuropathy, which makes it easy for them to injure their feet without knowing it.

“If you’re healthy, most small injuries to the feet heal on their own, but if you have diabetes, peripheral vascular disease or a neuropathy that impairs the sensation in your feet, small injuries can easily turn into ulcers that are difficult to heal and that can lead to amputation,” Singh says. “If you have these conditions, you should have any wound or sore evaluated right away.“

How to prevent foot ulcers

  • If you have diabetes, be sure you keep your blood sugars under control.
  • Check your feet every day to make sure you don’t have an injury you can’t feel.
  • If it’s too hard for you to examine your feet, ask someone else to look them over for you.
  • Protect your feet from injury by wearing socks and well fitting shoes.
  • Have a podiatrist (a foot specialist) evaluate any calluses or wounds.

Team approach
“But even with the best care, surgery is sometimes necessary to restore blood flow through blocked arteries,” says Singh.

Fortunately, UW Medicine is one of the leading centers in developing minimally invasive “endovascular” techniques that make it possible to open up many blocked arteries through small skin incisions without major surgery.

“While we can reopen a blocked artery, if the patient is not taught how to take care of their feet and care for a wound, the problem can just recur,” Singh says. “That’s why we’ve put together a team that includes specialists in internal medicine, wound care, vascular podiatric and orthopedic surgery, and physical medicine and rehabilitation. This approach assures that our patients will get the best care.”

The first step in feeling reassured you have a healthy vascular system is to get a vascular risk assessment. Schedule an appointment today by calling 855-520-5151.

Q&A with Dr. Singh

UW Medicine Health: Why do you choose to practice at UW Medicine?

Singh: Because of the expertise at UW Medicine, I know I have access to leaders in their respective specialty, which helps us acheive our goal to build a team approach to this difficult patient population and allow the patient to be as functional as possible.

UW Medicine Health: What is your approach to patient care?

Singh: I treat every patient the same way I would expect a surgeon to treat my family members or me. It involves giving the patient your best effort and settling for nothing less.

UW Medicine Health: Why do you enjoy working in vascular surgery?

Singh: In my specialty, we have a very unique elderly patient population that have complex problems. One of the greatest things about my experience in vascular surgery is that these patients have seen much in their lifetime and are a joy to work with.