Centro Internazionale per il Salvataggio d’Arto - Presentations - WHO Meeting

International Center for Limb Salvage

nationalcenterforlimbsalvage@gmail.com

The International Center for Limb Salvage is based in Geneva at the Geneva Foundation for Medical Education and Research (GFMER) and it has its clinical operative Center in Bologna, Italy, where the National Center for Limb Salvage of Italy is located at the Clinica Villa Torri.

Vision

The Center has been created to be an International Reference Organization, with local National sections in Europe and in the developing World, dedicated to Limb Salvage and to the prevention of Amputations and Limb Loss.

Mission

• To collect statistical and clinical data on the incidence and prevalence of  limb loss  and major amputations and to investigate all their causes including peripheral arterial disease (PAD), diabetes, gangrene, trauma, bone disease, infections, trauma.
• To provide evidence-based data, technical information, and on-site and centralized assistance to obtain such data.
• To research and collaborate in issuing recommendations on ethical issues concerning limb loss and amputation, and its social, economical, psychological and health impact.
• To investigate new techniques and to participate in perfecting established techniques for limb salvage by promoting, organizing and performing clinical and experimental research.
• To organize and participate in national and international educational programs to train physicians, nurses, medical and social operators in the field of limb salvage through prevention and advanced treatment.
• To help developing Countries identify their specific risk factors for limb loss and organize specifically designed programs to prevent amputations.
• To provide centralized know-how to assist in the treatment of  difficult cases of threatened limb loss.
• To help organize National Centers for Limb Salvage around the world , providing protocols, know-how and training for local operators.

About limb salvage

There are several causes  that may lead to limb loss. Trauma, both civilian and military, and diabetes are the leading causes. The increasing diffusion of diabetes in recent years is dramatically expanding the issue of threatened limb loss. Patients with diabetes have up to 70 times higher probability to develop gangrene and require amputation, when compared to the normal population. Infection, arterial occlusions, aneurysms and thromboembolism, AIDS, auto-immune diseases, all are significant causes of limb loss.

Limb salvage procedures may offer dramatic improvements to restore blood flow to the foot and prevent gangrene and leg amputations. Moreover, they improves the patient’s overall health and quality of life. The idea is to consider amputation as a procedure which should be avoided until reasonably possible, by enforcing an effective diagnostic and therapeutic regimen to save the limb.

Preventive measures include control of diabetes and thrombo-embolic disorders, education in self- assessment and self-examination of the foot, utilization of specially designed footwear to relieve pressure from high risk area in the foot of diabetics, use of properly designed trauma-protection devices to be worn by people exposed to accidental trauma.

Therapeutic measures include orthopedic, plastic, reconstructive and vascular surgery, interventional procedures with angioplasty and stenting of arteries, complex combined procedures. Accurate microbiology with cleansing and debridement of wounds and appropriate antibiotic management are essential in most cases.

A most important issue is to act immediately with an early diagnosis, reduction of risk factors and then management by properly trained  professionals.

Choosing an appropriate course of action is essential, because many limbs are lost due to "Supervised Neglect". "Supervised Neglect" is a faulty medical treatment that fails to inform patients of more effective treatments for their aliment: the treating physician therefore enforces therapies that are either  not up to date or ineffective. Patients, treated this way, receive attentive follow-up and frequent medical exams and lab testing, such as echo-doppler studies, intravenous therapy and repeated hospital admissions. This conduct enforces the illusion of being properly treated due to closed medical supervision when, in effect, an ineffective care is being given. The consequences of supervised neglect are such that initial minimal lesions, due to the disease, advance to a point when severe and destructive gangrene develops, prompting the unskilled physician to propose a major amputation as the only available option. Informing patiens and their families of the avalilability of highly specialized centers and of modern, advance, could let them have more possibilities to cure their disease and increase both quality of life and limb survival.

In depth Internet search has become an important source of information for all who seek state-of-the-art medical care, yet it remains the responsibility of the curing physician to help their patient in finding the right course of therapy. Patients should be made aware that most ischemic lesions, even the most adavanced ones, can often be cured in a conservative way, avoiding major amputations. 

About us / Contact

The International Centre for Limb Salvage is based in Geneva and is hosted by the Geneva Foundation for Medical Education and Research:

Geneva Foundation for Medical Education and Research
Villa Grand-Montfleury
Chemin du Grand-Montfleury 48
1290 Versoix - Switzerland

The clinical Headquarter of the Center for Limb Salvage is in Bologna at the:

Clinica Villa Torri
Centro Nazionale per il Salvataggio d’Arto
12, Viale Filopanti - 40126 Bologna, Italy
http://www.villatorri.it/

Phone: +39 3386933269
email: nationalcenterforlimbsalvage@gmail.com
Web site: http://www.villatorri.it/centro-internazionale-per-il-salvataggio-d-arto.htm

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Edited by Aldo Campana,