Limb Preservation

There are many conditions and factors that may put a person at risk for amputation. Sometimes a combination of factors can increase a person’s risk. Washington University Limb Preservation surgeons treat conditions including:

• Diabetic Foot Ulcers
• Critical Limb Ischemia/Chronic Limb-Threatening Ischemia
• Peripheral Arterial Disease
• Venous Disorders
• Other limb-threatening forms of trauma, wounds, lymphedema or vascular conditions

Second opinion before amputation

If you have been told you need an amputation, our multidisciplinary experts can provide an expedited second opinion regarding your limb preservation options.

Before your first visit, we will ask to see any previous tests you may have had. Seeing these tests will help our team plan for your treatment. Tests we may ask to see include:

• Previous vascular study labs
• Arterial blood flow ultrasounds
• X rays, CT angiograms or MR angiograms of leg blood vessels
• Previous advanced imaging, such as tissue concentration of oxygen
• Any prior pictures of leg blood vessels from angioplasty, stenting or atherectomy
• Any other lab tests

Our team may order repeat tests to see any changes in blood flow, disease processes or potential for healing. These tests will help us guide your therapy for the best outcome.

Washington University Limb Preservation surgeons provide high-quality care to save limbs and preserve function whenever possible. The Limb Preservation Program draws on multidisciplinary expertise in Vascular Surgery, Plastic and Reconstructive Surgery and Acute and Critical Care Surgery to ensure that you receive comprehensive treatment. These surgical treatments include:

• Angiography
• Vascular and endovascular surgery for arterial reconstruction or revascularization
• Wound Debridement
• Hyperbaric Oxygen Therapy
• Soft Tissue Reconstruction
• Flap Surgery
• Microvascular Surgery
• Bone Reconstruction

Treatment for limb-threatening conditions can have a lengthy recovery process. Our team will guide you through each step of this process, from preop visits before surgery to your time in the hospital and any rehabilitation after surgery.

Your capacity to recover will be part of the planning process before any procedure. The limb preservation team will help select the best rehabilitation for your needs. This can include inpatient rehabilitation, in-home rehab or follow-up outpatient care.

Continuity of care is the most important part of your recovery and rehabilitation. Limb-threatening conditions have a high rate of recurrence, meaning that the problems can come back over time. We will stay with you, checking in on your condition and providing all needed follow-up care, to make sure you have the best possible outcome.

Full recovery from complex limb conditions may take weeks or months. Our goal is to get you back to the highest possible level of movement (also sometimes called ambulatory function).

We strive to save limbs whenever possible. Our team considers every possible option to avoid amputation. If amputation is necessary, we have a specialized rehabilitation team with access to innovative techniques and advanced prostheses to achieve maximum use of your prosthetic limb.

While you have access to all of the experts on the Limb Preservation Team, not all patients will need to see every type of specialists.

Our team will help guide you through the appointment and treatment process so that you see all the experts that you need in as few visits as possible.

We provide care at clinical locations across the St. Louis region. Depending on your condition, you may be able to receive most of your care from a Washington University Physician at a convenient area clinic.

Our experts are leaders in limb preservation techniques and treatments. Washington University Physicians are nationally and internationally recognized for their involvement in innovative clinical trials to improve treatment options.

Studies show that a coordinated, multidisciplinary limb preservation program significantly improves the chances of avoiding major amputation when faced with limb threatening conditions.

With clinical locations across the St. Louis region, we can provide the necessary follow-up care to ensure the best long-term outcomes.

We appreciate the opportunity to care for your patients, and we have designed our processes around making these complicated care pathways as efficient and comfortable as possible for your patients.

Our team keeps referring physicians continuously updated and involved in the long-term care of their patients with limb threatening conditions.

The Washington University Limb Preservation Program combines expertise in Podiatry, Acute and Critical Care Surgery, Plastic and Reconstructive Surgery and Vascular Surgery to meet the needs of our patients. Meet our surgeons who specialize in limb preservation below.

Grant V. Bochicchio, MD, MPH

Edison Professor of Surgery

Chief, Section of Acute and Critical Care Surgery
Division of General Surgery

Sara A. Buckman, MD, PharmD

Associate Professor of Surgery

Section of Acute and Critical Care Surgery
Division of General Surgery

Kelly Currie, MD

Assistant Professor of Surgery

Division of Plastic and Reconstructive Surgery

Nathan Droz, MD

Assistant Professor of Surgery

• Phone: 314-273-7373

Division of Vascular Surgery

Bradley D. Freeman, MD

Professor of Surgery

Section of Acute and Critical Care Surgery
Division of General Surgery

Patrick J. Geraghty, MD

• Phone: 314-273-7373

Professor of Surgery and Radiology
Section of Vascular Surgery
Division of General Surgery

Mark H. Hoofnagle, MD, PhD

Assistant Professor of Surgery
Section of Acute and Critical Care Surgery
Division of General Surgery

Obeid N. Ilahi, MD

Associate Professor of Surgery

• Phone: 314-362-5298

Section of Acute and Critical Care Surgery
Division of General Surgery

Vipul Khetarpaul, MD

Associate Professor of Surgery

• Phone: 314-653-5138

Section of Vascular Surgery
Division of General Surgery

To get in touch with our limb preservation team, please call 314-273-5462 (LIMB).

For any emergent or time-sensitive limb preservation needs, please visit the Limb Preservation Team at the Charles F. Knight Emergency and Trauma Center at Barnes-Jewish Hospital.

Charles F. Knight Emergency and Trauma Center Location