Limb Salvage Surgery in Los Angeles

Dr. Patel can often use microsurgical techniques to salvage or restore threatened limbs, whether the damage is caused by trauma, diabetes, or other diseases. The restoration of proper blood flow may help patients avoid amputation.

Even in patients with vascular disease, Dr. Patel is able to reconstruct soft tissue through skin transplantation. He works closely with talented doctors and surgeons who specialize in other disciplines, such as vascular surgery, podiatry, and orthopedics to offer the best chance of preserving or restoring mobility and quality of life.

Conditions We treat With Limb Salvage Surgery

picture of older lady who has diabetes

Candidates For Limb Salvage Surgery

Limb salvage surgery may help:

  • Patients with chronic wounds that have been open for several months or have underlying bone infections. Dr. Patel uses innovative microsurgical and super-microsurgical techniques to transplant small pieces of tissue to the foot and ankle. The surgery closes the wound and creates the ideal conditions for bone to heal.
  • Patients with trauma, exposed bone, or exposed vital structures. Typically, these wounds won’t heal on their own. Dr. Patel uses innovative flap surgery techniques that can allow a wound to close and heal faster than with traditional wound care methods.

What Is Flap Surgery?

Dr. Patel takes tissue from one of several areas around the body, using microsurgical techniques to nourish the new tissue and help ensure the best possible results.
Whenever possible, he takes tissue from places that most closely match the area of the wound, and uses that tissue to repair and reshape the affected area.

For example, on the foot and ankle, the skin is very thin, so Dr. Patel matches this by taking thin flaps from the groin or thigh region. This allows for a better contour and easier fit with shoes. Dr. Patel is one of the most experienced surgeons in the United States with doing ultra-thin flaps that better match the contours of the foot and ankle.

The Difference Between Flap Surgery And A Skin Graft

Yes. A skin graft has no blood supply, which means the survival of the graft depends on new blood vessels growing.

A flap surgery brings intact blood vessels with the transplanted tissue. Dr. Patel uses microsurgical techniques to connect the new blood vessels to existing blood vessels in the area, meaning that the new skin has a much better chance of thriving.

Benefits Of Limb Salvage Surgery

Over 60 percent of nontraumatic amputation are due to diabetes complications, such as foot ulcers, peripheral neuropathy, and peripheral vascular disease. Limb salvage surgery by Dr. Patel and other skilled surgeons can enable the patient to retain leg function, be free of infection, and minimize future complications.

By being able to keep their limb, these patients are able to keep using the limb, retain independence, and maintain a higher quality of life. Studies have shown that patients with primary amputation have a 30 percent increased incidence of depression. Plus, amputation results in much higher rates of mortality. Studies place mortality following primary amputation at around 40 percent.

What are the risks Of Limb Salvage Surgery?

The risks involved with these procedures are generally that the flap will not successfully work, and the patient will still require amputation or another attempted salvage surgery. When considering the high rates of mortality after amputation, coupled with the roughly 91 percent success rates of flap surgeries in these types of cases, it can be the best first option for most patients. The real risk is going ahead with amputation when the patient may have had the option of keeping his or her limb.

How to prepare for flap surgery

Preparation depends, in part, on your circumstances. If the injury is due to trauma, obviously there isn’t any preparation on your part, as it is likely an emergency situation. For more vascular issues, such as those related to diabetes, your preparation will be the same as it would be for any major surgery. You will need to stop taking any blood thinners, aspirin, anti-inflammatory medications, and most herbal supplements for at least one week prior to your surgery with Dr. Patel. All of these can lead to excessive bleeding. If you smoke, you’ll need to stop for at least two weeks prior to your surgery and afterwards, as smoking restricts the blood vessels, and this impedes healing.

Preparation should also take into account your recovery. If Dr. Patel is operating on your foot of ankle, your mobility will be limited, especially for the first week or so. You’ll want to create a recovery nest that is ultra-comfortable and complete with all the entertainment you’ll need right at your fingertips.

Your recovery and particulars will depend on your unique situation, and we will discuss your preparation in detail at the process moves forward.

Is flap surgery painful?

Recovery from flap surgery will involve two areas, the repair site and the area where the flap was taken. There will be some discomfort, but it is manageable with the prescription pain medication Dr. Patel will provide. After the first week or so, your discomfort should decrease daily.

How Long Are Flap Surgeries?

Surgery usually takes 4–6 hours, though if there are bone- or tendon-related issues, the surgery may take longer. Dr. Patel may also partner with another specialist such as an orthopedic surgeon, podiatrist, or vascular surgeon.

After a flap surgery, patients usually stay in the hospital for about a week to ensure that the flap heals and joins well with the surrounding tissues.

What can I expect from my results with flap surgery for limb salvage?

We note the success rates for these procedures elsewhere on this page, and large amounts of research specific to these surgeries is difficult to find. But most studies have shown foot reconstruction and salvage in diabetic patients to be over 90 percent. After five years, the limb survival is 87 percent.

What does that mean for your life? When Dr. Patel is able to use flap surgery successfully, your chronic open wound or persistent ulcerations on your foot and ankle will finally heal. That means you’ll be able to use the limb again, as it was severely compromised by the chronic wounds. That means walking around the block with the dog again, walking around the grocery store, walking as a means to improving your circulation and your overall health.

Regaining use of a leg or foot is obviously incredibly important to your quality of life. Equally so is simply keeping the limb. These flap procedures used by Dr. Patel can usually keep the patient from needing to have the leg or foot amputated. That makes a huge difference in your quality of life moving forward.

What To Expect During Recovery

As you would assume, there is not a “set” process or timeframe for recovery from these complex procedures performed by Dr. Patel. If the flap is not on the bottom of the foot, the recovery tends to be quicker. Overall though, complete healing for these flap surgeries can be slow. It’s typical to expect a wide range of healing rates, everything from 6 months to one year. These are not fast recovery times, but when compared to the alternative, amputation, their success rates of 90 percent and higher are certainly worth the wait.

What Our Patients Have To Say

“Dr. Patel is very good at what he does and is very thorough in explaining procedures and outcomes. I was very satisfied with the procedure that he did. He recommended what was best for my situation.” -Martha R.

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How Long Before I Can Exercise Again After A Limb Salvage Procedure?

There is no timeline for recovery, much less returning to exercise. It’s probably safe to say that most patients can return to some level of exercise using the salvaged limb within one year. But every case is unique.

As your process runs its course, Dr. Patel will keep you informed of what he anticipates will be your recovery process and timeframe.

What exercises and lifestyle choice maintain flap surgery results?

Limb salvage You will certainly want to work to maintain your newly healed leg or foot. The key is improving your circulation. Since you have narrowly avoided possible amputation of the leg or foot, you now have ample incentive to work hard to improve your circulation.

Here are a few helpful lifestyle changes toward that end.

  • Get moving — Probably the best thing you can do to improve circulation is to exercise regularly. Start with walking but work up to aerobic levels if you can. Aerobic means “with oxygen.” When you run, bike, walk faster, swim, or take a workout class, you take in more oxygen and move it to your muscles. This gets your blood pumping, makes your heart stronger, and lower your blood pressure. Set a goal to exercise 30 minutes, 5 to 7 days a week. If it’s walking, you’ll want to be at a speed of at least 3 miles per hour.
  • Stop smoking — Nicotine in cigarettes (including e-cigarettes) harms the walls of your arteries and thickens your blood so much that it can’t get through. And you don’t want decreased blood flow to your legs and feet.
  • Control your blood pressure — High blood pressure can cause arteriosclerosis, hardening of the arteries, and this chokes off blood flow. Aim for 120 over 80 or less.
  • More water — About half of your blood is water. Stay hydrated to keep it moving. Aim for 8 glasses of water a day, more when exercising or during hot days outdoors.
  • Standing desk — You may think standing desks are a passing fancy for younger co-workers but sitting for hours every day is tough on circulation in your legs, not to mention the strength of your lower back. A standing desk helps to work the valves in your leg veins, making them work better for that blood returning to your heart.
  • Strike a pose — Yoga is an excellent low-impact exercise that jump starts your blood flow. Moving sends oxygen to your cells. Twisting sends blood to your organs. Upside down yoga positions shift blood from the bottom half of your body up to your heart and brain.
  • Put your legs up the wall — OK, so yoga’s not for you. You can still do a yoga pose that’s great for your circulation. It’s called viparita karani. Lie on the floor with one shoulder close to the wall. Turn your body so you can put your feet up and move your bottom to the base of the wall. Straighten your legs somewhat with your feet above you on the wall. Stretch your arms outward for balance. This is a great thing to do if your ankles or feet have swollen.
  • Squat — Squats are great for strength in your legs and core. Start with your feet shoulder-width apart and your arms out in front of you. Slowly bend at your hips and knees but keep your back straight. Keep your arms out in front or put them on your hips. It’s like you’re sitting in a chair. Then rise up and repeat. Be sure to keep your knees equal with or behind your toes when squatting.
  • Wear compression socks — When you have poor circulation in your legs, it’s at least partially due to your tissues no longer helping push the blood upward as they did when they were tighter and stronger in your younger days. Wearing compression socks mimics this by squeezing your legs to help push the blood upward.
  • Get serious about better food — Everyone thinks about eating more fruits and vegetables, and then they head to lunch at the fast-food joint. There isn’t any downside for a balanced diet and avoiding processed foods, too much red meat, and too much fat and salt. This keeps your blood pressure in a healthy range and lowers your cholesterol.

How Successful Are Limb Salvage Procedures?

Most studies have shown success for diabetic foot reconstruction and salvage to be over 90 percent. The five-year survival rate for the limb is around 87 percent.

With successful salvage, the patient is able to regain use of a limb that either had a chronic foot wound or persistent foot ulcers and infections. Chances are the patient wasn’t able to use the limb. Avoiding amputation not only saves the limb, but it will usually also enable the patient to regain function.

Schedule A Reconstructive Surgery Consultation With Dr. Patel

If you would like to learn more about our Limb Salvage Surgery procedure to see if it is the right option for you, contact us today at 323-442-7920. Our practice serves Glendale, CA, Los Angeles, CA and the surrounding areas.

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