Early Intervention to Prevent Amputation
The Limb Preservation Program at Palmdale Regional Medical Center (PRMC) focuses on prevention and early intervention to heal conditions affecting the legs, feet and toes and help prevent the loss of a limb. Our goal is to help prevent amputation, which normally results in a reduced quality of life.
The program can benefit people with diabetes and can also help those with bone infections, leg swelling, surgical wounds, pressure sores, radiation injuries or other injuries to the arteries. We can help patients who have been diagnosed with:
- Cold limb
- Atrophied limb
- Black limb
- Ischemic gangrene
- Lower limb infection
- Diabetic ulcer
Meet the Limb Preservation Team
Kyle Hopkins, DPM, Program Director
Dr. Hopkins is a board-certified foot and ankle surgeon specializing in foot trauma and fracture care, podiatric surgery, sports medicine, wound care and regenerative medicine. He works in the hospital on all foot traumas, as well as in his community clinic prescribing orthotics to help people's feet, performing nail surgery, sports medicine and injury, and diabetic care.
Schedule an Appointment with Dr. Hopkins or call 661-726-5005.
Ihab N. Aziz, MD, Vascular Surgeon
Schedule an Appointment with Dr. Aziz or call 818-401-1010.
George M. Makkar, MD, Vascular Surgeon
Schedule an Appointment with Dr. Makkar or call 818-401-1010.
Ian R. Cook, MD, FAPWCA, Medical Director, Wound Care and Hyperbarics
Call the Center for Wound Care and Hyperbaric Medicine at 661-949-6946 to contact Dr. Cook.
The Limb Preservation Process
A successful limb preservation program engages patients at many stages along the spectrum of care. An organized program requires well designed patient processes, multidisciplinary collaboration of physicians, and a foundation of community physician clinics, hospital-based services and outpatient wound care. PRMC has a set foundation of services that require planning and collaboration to fully utilize.
Joining the Program
Patients can present to the program in three ways: from an emergency room, wound care center visit, or community outpatient setting for diabetic foot wound or condition. A series of baseline tests are first performed to establish the patient's condition. The patient is then admitted or referred to a hospitalist, and a vascular team, podiatric surgeon and infectious disease specialist are consulted to define the treatment plan. Provider alignment and engagement is maintained by organizing a “vascular board” or “vascular section” meeting where cases are discussed and treatment plans are developed in interdisciplinary meetings.
The program uses a variety of medical specialists, including wound care, cardiology and podiatry, who work together to develop a comprehensive care plan that will improve circulation and promote healing. While in the hospital, the patient will require consultations from an endocrinologist, case management, wound care and dietary. The patient will have orders for adjunct therapies as needed based on the level of procedure they undergo. Partial amputations and application of biologic grafts may be performed to promote healing and wound closure.
If preservation is not an option, we will utilize the same treatment team and resources to ensure a safe amputation that best prepares the patient for a prosthesis and helps prevent any further deterioration in the future. If amputation is necessary, the goal is to limit its scope and severity, and connect patients with additional resources for rehabilitation and therapy.
Return to Home
Patients will heal and prepare for return to home through multiple modalities. Downstream visits will be with outpatient wound care, home health, and physical therapy. The patient will also follow up with community physicians for further treatment, evaluation and preventive care for their condition.
There are several distinct elements of the program that will utilize PRMC and our adjunct service lines:
- Full contact casting
- Outpatient rehabilitation therapy
- Wound care services with and without hyperbaric oxygenation treatments to promote healing
- Wound Vac application and sponge changes in wound care clinic
*Many of these patients will be a planned readmission to perform closure of the wound following biologic grafts healing and adherence.