Major leg amputations have decreased “dramatically” over the past seven years, dropping by more than a third last year.
The number of amputations went down from a “peak” of 133 in 2003 to 89 last year through a heavy government investment in financial and human resources, Health Minister Joe Cassar said.
The drop is linked to a number of factors but the key component has been early intervention on patients who run the risk of losing an extremity due to poor blood circulation, mostly diabetics, who form 90 per cent of this group.
In such cases, rather than amputate, surgeons would instead carry out an artery bypass or an angioplasty, where a small balloon is inserted in a vein and inflated to widen it, consultant vascular surgeon Kevin Cassar explained.
Prof. Cassar was speaking while performing an artery bypass, which was being carried out in a theatre connected via a video link to another room where the minister and journalists could follow.
Besides increasing the patients’ quality of life, such procedures diminish risks for patients, seeing that between 10 and 20 per cent of amputees do not live through the first month.
However, the culture of seeking help early is still not diffused enough.
Former patient Joseph Vassallo, 64, encouraged people needing the surgery not to be afraid, especially after he underwent four leg bypass surgeries in the past four years. “I realised something was wrong when my left shoe was fitting very tight. In fact, I thought my shoe had shrunk because my wife had polished it too much,” he said jokingly.
But it was no laughing matter when he noticed his big toe had turned black. “When I went to hospital, they told me that gangrene had already set in and they sent me for an operation immediately,” Mr Vassallo, of Kappara, said.
The bypass was successful and the toe was saved and started healing. Soon enough, he started walking to keep fit. But, soon after, he had to undergo another operation because of a blood clot in his left calf.
“I felt this intense pain. It was as though someone kicked me and I knew something was wrong,” he said.
With the last bypass performed around three months ago, Mr Vassallo says he feels fully fit and goes for his daily 1.5 hour walk with his wife. “Recently, I repainted the whole house with the help of my wife,” he said.
Prof. Cassar pointed out that some people sought help too late. “Some come to hospital at the very last minute because they are afraid but then it’s too late. Other patients refuse to have a toe removed and end up having to face major surgery,” he said.
The Health Minister said the government had invested in a strategic manner in this area, making best use of both specialists and equipment, such as a CT-scanner – to provide high quality images of blocked arteries – and a device to measure blood flow to the feet and toes.
On top of that, a new unit, managed by nurses, was tasked with identifying patients with vascular problems, also contributing to the success of the alternative procedures put in place, Dr Cassar said.