“Slow healing above the knee amputee - can it be helped?”
I need to know what can happen, in the terms of treatment, with slow healing found after above-the-knee amputation. This started as a circulation issue, due to a weak heart. I was told that "lower leg died". It could not heal the infection. After amputation, I am being told the wound is healing slowly. If I (actually my wife) is found not to be able to heal the surgery scar, then what? The doctors who care she is under sound like she just dies. Is there nothing in this whole world that can address this? She is very much alert and responsive, not like she's in a vegetative state. There's got to be a way?
Female | 60 years old
Complaint duration: 2 months
Medications: Insulin
Conditions: Weak heart, pre- diabetes
3 Answers
Hi there,
Your question is hard to answer definitively without seeing it and every case is different. Also Im an ER doc with 20+ years, but not a vascular doc.
However, just for a little reassurance. Most patients requiring an amputation outside of a traumatic event do so for vascular reasons. Guessing your wife has significant vascular disease which may be due to her heart and diabetes. As a result of poor blood flow to and from her legs, especially the furthest parts, she probably has had trouble healing wounds that you would expect to heal more quickly. She probably ended up with several wounds, infections, and admissions and finally someone said hey, she cant heal because her blood flow is so poor to her legs. So the idea is to amputate high enough that she now has adequate blood flow to heal after surgery and yet only take as much as you have to. Its an art!
So it sounds like she is healing slowly. She could really benefit from a “Wound care center” Should be part of a local health care center so call a couple close hospitals and simply ask for a wound care center. This is not rocket science! Her primary, her surgeon, and her admitting doctor (the hospitalist) should all be well aware and should also be able to refer you as well.
They do many specialty bandages and wound vacuums and sometimes hyperbaric chamber treatment. Lots of cool things and lots of it is directed at healing poorly vascularized wounds! You are far form alone and her problem is far from unique.
Some wounds never heal. Just inadequate blood flow or some other reason but its uncommon and you should feel confident that she will heel as well. Just dont be in a hurry because it can take months and partner with a wound care center. They will get you there.
Hope that helps.
Your question is hard to answer definitively without seeing it and every case is different. Also Im an ER doc with 20+ years, but not a vascular doc.
However, just for a little reassurance. Most patients requiring an amputation outside of a traumatic event do so for vascular reasons. Guessing your wife has significant vascular disease which may be due to her heart and diabetes. As a result of poor blood flow to and from her legs, especially the furthest parts, she probably has had trouble healing wounds that you would expect to heal more quickly. She probably ended up with several wounds, infections, and admissions and finally someone said hey, she cant heal because her blood flow is so poor to her legs. So the idea is to amputate high enough that she now has adequate blood flow to heal after surgery and yet only take as much as you have to. Its an art!
So it sounds like she is healing slowly. She could really benefit from a “Wound care center” Should be part of a local health care center so call a couple close hospitals and simply ask for a wound care center. This is not rocket science! Her primary, her surgeon, and her admitting doctor (the hospitalist) should all be well aware and should also be able to refer you as well.
They do many specialty bandages and wound vacuums and sometimes hyperbaric chamber treatment. Lots of cool things and lots of it is directed at healing poorly vascularized wounds! You are far form alone and her problem is far from unique.
Some wounds never heal. Just inadequate blood flow or some other reason but its uncommon and you should feel confident that she will heel as well. Just dont be in a hurry because it can take months and partner with a wound care center. They will get you there.
Hope that helps.
Consult Functional Medicine.
Hello, I am not an expert in vascular surgery, however, my partner is. He recommends seeking out hyperbaric oxygen treatment. I wish you the best of luck and a quick recovery.
