Amputation
The amputation of a body part is always the final stage of a treatment sequence. This alternative would only be considered in cases of absolute therapy failure or tissue that can no longer be saved.Unfortunately, the existing circulatory disorder has often caused very extensive damage to the tissue over a very long period of time, so that amputation of more or less large parts of the leg is the last resort. This can be the amputation of individual toes, the removal of the entire forefoot or sometimes the entire foot with or without parts of the lower leg.
However, as long as other options are available, we would do everything possible to make use of them and to preserve the leg if possible. Nevertheless, some patients report the relief they have experienced through amputation; the problem has been finally eliminated. Individual views and disease theories play just as important a role as the advice of the treating physician and the individual suffering of the individual.
An amputation is necessary when the open area has become infected and the infection can no longer be controlled. The circulatory disorders that cause open legs also prevent the open areas from closing up again. The poor circulation also makes it difficult to combat pathogens. Infections can quickly get out of control. Another cause of amputation can be the death of tissue on the leg.
Diagnosis
The diagnosis of the open leg is usually made clinically, i.e. by questioning and examination by the doctor. A special ultrasound examination of the vessels in the leg (Doppler sonography) and an X-ray examination with a contrast medium (phlebography with contrast medium, angiography) can also be helpful for special questions, such as suspected thrombosis or to assess the status of the arteries. In addition, other possible causes of non-healing wounds should also be clarified; a blood sample should therefore also be taken to detect disorders in the sugar or fat metabolism or in the coagulation system. In addition, a sample can be taken from the affected tissue and examined if there is a suspicion that the vessels are not the cause of the open leg in this case. If, for example, the colonization of the wound with a germ is detectable and the cause of the open leg is this infection, an antibiogram of the pathogen should finally be prepared in order to start an optimal antibiotic therapy.
