When Limb Salvage Becomes Heartbreaking

DMCA.com Protection Status

By Aletha Tippett MD

What? How can limb salvage be heartbreaking? Isn't it great to save a leg and a life? Of course, that is all wonderful and is what keeps you going in this very difficult field. What is heartbreaking is when you have worked so hard and are winning the game, only to have your patient swooped away by others and the limb is amputated without ever being contacted or consulted.

The Loss of a Limb Salvage Patient

Over the past decade this has happened to me several times, but recently it happened again. We had been caring for an elderly patient with diabetes who was on renal dialysis and who had a number of wounds on her foot. She had a heel eschar, a large plantar surgical wound, and two or three other small abrasion-type wounds. We have been treating her every two weeks for several months, including maggot therapy which she wanted, and had seen excellent results with her wounds. All wounds were healing very well and were not long from closing. We were on the phone the other day sharing lab information with the patient's dialysis unit and they said, “well, if she comes back.” We said, “what do you mean?” They said the last they heard she was at a major university hospital with plans to amputate her leg. We were sick at heart to hear this. We won't know the outcome for some time. It almost makes you want to give up—why can't there be communication between facilities and physicians?

Cornerstones of Amputation Prevention: Communication and Education

Lack of communication is a problem in health care in general, and for limb salvage in particular. There was one case, however, where communication was there and I spoke personally to the physician, begging him not to amputate my patient because it could kill him. The next day he proceeded with the amputation and by that evening my patient was dead. More heartbreak.

So, in the field of limb salvage, some glaring difficulties are lack of communication and differing opinions on the value of limb salvage. I will not stop limb salvage efforts, but there needs to be continued education on the importance and value of limb salvage. It also reminds me how very vulnerable these patients are and how deserving they are of the best care they can receive.

About The Author
Aletha Tippett MD is a family medicine and wound care expert, founder and president of the Hope of Healing Foundation®, family physician, and international speaker on wound care.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

Recommended for You

  • post-surgical cancer patient
    November 14th, 2017

    By Janet Wolfson PT, CLWT, CWS, CLT-LANA

    So, if you are following my series on the lymphatic system, then recall that last month the topic was causes of lymphedema. Today I will dive into how modern medical care and disease processes can affect the lymphatic system

  • Wound Care Literature Review
    November 19th, 2015

    By Temple University School of Podiatric Medicine Journal Review Club

    Editor's note: This post is part of the Temple University School of Podiatric Medicine (TUSPM) journal review club blog series. In each blog post, a TUSPM student will review a journal article relevant to wound...

  • lymphedema management and prevention
    January 18th, 2018

    By Janet Wolfson PT, CLWT, CWS, CLT-LANA

    With increased awareness of the impact of the lymphatic system on all other systems of the body, there are now multitudes of research studies on lymphedema and thus new approaches and treatments by the medical profession. These include...

Important Notice: The contents of the website such as text, graphics, images, and other materials contained on the website ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The content is not intended to substitute manufacturer instructions. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or product usage. Refer to the Legal Notice for express terms of use.