Diabetic lower limb arterial bypass surgery

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Diabetes is a major cause for amputations in the UK. This is because diabetic patients have leg problems caused by an impairment of the peripheral nerves (neuropathy), blockages in the arteries (arteriopathy) and an increased risk of infection (immunopathy). Diabetic foot complications cause loss of sensation, foot shape deformity, ulcers, gangrene and potentially limb loss. It is vital that patients with diabetes learn about foot care from their podiatrist or GP.

Patients who have diabetic foot vascular complications will be evaluated with a transcutaneous oximeter and ankle brachial pressure index readings in the clinic. Further special investigations such as an arterial duplex scan, a MR Angiogram or a CT Angiogram may be required. Most patients can be treated with minimally invasive techniques such as angioplasty or stenting. These procedures are often done as day cases or require overnight stays. However it may not be possible to treat all patients with extensive or recurrent arterial disease with minimally invasive techniques. Suitable patients with extensive arterial disease will be assessed for arterial bypass surgery. Patients undergoing arterial bypass surgery stay 7 to 14 days in hospital and often require input from tissue viability nurses, physiotherapists and occupational therapists as part of their recovery programme.   

Mr. Chong provides vascular surgical expertise to the multidisciplinary diabetic limb salvage clinic at Frimley Park Hospital. In this service, he works with colleagues in diabetes medicine, orthopaedic foot and ankle surgery, podiatry, tissue viability services and microbiology to preserve limb function in high risk patients so that they achieve the best quality of life possible.