Limb Preservation

Holistic limb salvage care.

Get specialized treatment for diabetic foot ulcers and other slow-healing wounds before they threaten your mobility or loss of limb.

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Why limb loss occurs

When neglected, vascular disease and diabetes make you more vulnerable to limb loss. Peripheral artery disease, for instance, can slow healing in your legs and feet, while diabetic neuropathy may prevent you from even noticing the wound. Left untreated, such wounds can lead to life-threatening infections that can only be stopped by amputating the infected limb. Since complications can occur rapidly, getting treatment as soon as possible is critical.

Conditions that can threaten your limbs

The limb preservation program at Novant Health focuses on treating limb-threatening conditions related to vascular disease and diabetes. These conditions include:

  • Peripheral Arterial Disease (PAD): A narrowing of blood vessels in the arms and legs.
  • Diabetic Foot Ulcers: Open wounds that usually occur on the bottom of the feet.
  • Diabetic Foot Pain: Nerve damage causing pain and numbness that makes some with diabetes more prone to injury and infection, especially if sensation is reduced.
  • Venous Leg Ulcers and Leg Wounds: Non-healing leg and ankle wounds caused by damaged veins, injuries and blood clots.
  • Critical Limb Ischemia: An advanced form of PAD where severe blood vessel blockages occur.
  • Complex Foot and Ankle Deformity: Conditions like Charcot (pronounced shar-CO) arthropathy that reduce sensation and increase susceptibility to injury and infection.
  • Arterial Occlusive Disease: A narrowing of arteries throughout the body.

Limb Preservation Treatment Options

Diabetic foot complications, including foot ulcers, require routine and preventative foot care. Daily wound care is necessary to reduce and prevent problems. Nonsurgical treatment for Charcot foot includes rest, immobilization and orthotics. Surgery may be needed for severe cases.

Managing and preventing chronic nonhealing wounds may include topical treatments, specialized dressing, medications and debridement (the removal of damaged tissue). Hyperbaric oxygen, negative pressure and cellular tissue therapy may also be recommended, and surgery may be necessary for advanced cases.

Exposing wounds to 100 percent oxygen at high pressure has been known to improve healing. This treatment is performed in a hyperbaric oxygen chamber specially designed for oxygen immersion.

Vascular surgery, including minimally invasive endovascular procedures and vascular reconstructive and bypass surgery, may be recommended. These procedures improve blood flow due to blockages or narrowing (stenosis) of the blood vessels.

Reconstructive surgery may be necessary for limb salvage and to treat foot and ankle deformities. Limb preservation may require the removal of tissue or bones and may involve partial amputations that still allow mobility.

Orthotics provide support and alignment for the foot and ankle to help with stabilization and balance, mobility, pain reduction and chances of injury. If amputation cannot be avoided, advanced prostheses are available.

Novant Health offers comprehensive rehabilitation services for wound care, vascular surgery and amputation, including fitting and use of prostheses. Rehabilitation focuses on restoring mobility and providing the tools and education to prevent reinjury and wounds and build healthy habits.

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Your multidisciplinary limb preservation team

Because loss of a limb can result from multiple health factors, your core care team will be led by a team of specialists, including a:

  • Vascular Surgeon: Vascular surgeons will typically lead your multidisciplinary limb preservation team due to their expertise in restoring the smooth flow of blood critical to wound healing.
  • Reconstructive Surgeon: These specialists might be called in to preserve or restore function and normal appearance of a limb should you require removal of tissue or bone to treat your wound. General, orthopedic, plastic or vascular surgeons may perform such procedures.
  • Hyperbaric Medicine Specialist: These physicians determine whether you would benefit from this treatment and, if so, set the breathing gas mixture used to treat you and the duration and frequency of your treatments.

This core care team will coordinate with cardiologists, endocrinologists, podiatrists, orthopedic surgeons, infectious disease, orthopedic and other specialists that care for you to create your treatment plan.