THE number of lower limb amputations in diabetic patients in Swindon are almost double the national average.

New figures show that in 2008/09, there were 32 hospital procedures for amputations in diabetic patients in NHS Swindon – a rate of 17.25 per 100,000 population.

When compared to the national rate of just 10 in 100,000 and 12 in the south west, the picture becomes clearer.

The cost of these operations to the health service per patient has been described as very significant and, with estimations that there are currently 1,535 adults with diabetes undiagnosed in the town, the problem shows no sign of slowing down.

But with diabetics 15 times more likely to have a limb amputated due to infection or poor blood supply, a specialist in-patient multi-disciplinary team has been set up at the Great Western Hospital, funded by the hospital.

These teams have been shown to reduce below knee amputation rates by as much as 80 per cent, while also saving costs for the NHS.

Diabetic foot co-ordinator Matthew Cichero is part of the team, which has been in place for eight months.

He said: “Patients who come to me will have an acute condition.

“I check the blood supply, check for infections, either in the bone or soft tissue, the type of bacteria present, the diabetes control, and the co-morbidities behind it, such as kidney problems or retinopathy, which can lead to blindness.

“I will talk to them about what is happening to their foot, the proposed management of the situation and also ensure that the links are in place when they leave the hospital to provide continuity of care once they have received their treatment here.

“Our main aim is limb preservation – to prolong life and improve the quality of life for patients, as well as reduce costs for the NHS.”

Matthew usually manages six to 10 patients at one time and this not only involves treatment at his clinic, but will also include managing them as an in-patient.

“It’s time-intensive and hands-on,” he said.

“We have had some very good results in the past six months: The average hospital stay of a patient was at 34 days and is now at 24 days.

“The amputation rate has also been reduced.

“It’s the gold standard of diabetic foot management which, as a podiatric surgeon, we strive to get to.”