Vascular surgeries can avert amputations – Dr Ravul Jindal

Shimla: Rising incidence of diabetes and trauma cases because of road accidents would require many more vascular surgeons than there are presently in the country, as the super-specialty field of surgery could avert many amputations and help to reduce the health burden thus caused.

Interacting with the media Ravul Jindal, executive member Vascular Society of India (VSI) and head of Vascular and Endovascular Surgery at Fortis Hospital, Mohali said that the country lacked data on peripheral arterial disease (PAD) which inflicts legs and arms and if not treated in time fast develops into gangrene leading to amputations.

High prevalence of smoking and increasing population of diabetics have a direct bearing of vascular diseases of the extremities, he said. Other reasons causing the disease are old age, high cholesterol and hypertension, he added.

Risk factors result in blockade of blood vessels in leg resulting in loss of blood supply to foot with consequences such as infection, non healing ulcer and gangrene (blackening of toes).

Unfortunately these diseases are not diagnosed on time and patients ultimately land up with gangrene and consequent limb amputation,” Dr Jindal adding that absence of early diagnosis worsened the problem.

Its onset of peripheral gangrene that reveals absence of pulsations for long periods of time hitherto unnoticed. After diagnosis also only treatment of these cases has been amputations leaving primary vascular problem unsolved.

Lowering blood pressure, bad cholesterol levels, managing blood glucose and regular exercises are best ways to prevent these diseases.

In accident victims, where blood supply to limbs may have got damaged need repairing of the vascular system within 6 hours of the emergency, if the limb is to be saved. In Himachal where rate of grievous injuries per accident is very high, victims should be shifted to tertiary care institutions for timely intervention, said Jindal.

The doctor who had received advanced training in the specialty in UK, says no medical institution in India was offering advanced courses in vascular surgery, where in the developed world no hospital which handles emergencies could be run with a vascular surgeon on its staff.

He claimed that there were only about 65 vascular surgeons in the country of which there were only 6 in North India. There are too few of us to handle increasing numbers of patients with PAD and other vascular diseases, and awareness and preventive measures are needed, said Jindal.

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