The department of Endocrinology, Diabetic lower limb and Podiatric surgery, Amrita Institute of Medical Sciences and Research Centre (AIMS), Kochi, conducted its two days annual Amrita Diabetic Foot Conference (ADFC 2011), in the institute which concluded on 7th May ‘11. It was a very successful attempt in bringing forth the problems, as well as the solutions, faced in the treatment of the diabetic foot, thanks to the tireless efforts of the organising secretary, Dr Ajith Kumar Verma.The conference was attended by about 275 delegates, including four guest faculties from abroad. Two of the foreign guest faculties-- Dr.Sarnarendra Miranpuri, Dr.David Neilson-- are highly competent and famous podiatric surgeons from the U.S. The foreign guest faculty also included Dr.Christy P. Sankoorikal a highly experienced endocrinologist from Australia, and Dr.Sunita Nair, chief of a major wound care centre in Chicago.
The theme of the conference was prevention of major amputations in diabetic lower limb wounds. By comprehensive management including 'Reconstructive foot and ankle surgeries' in deformed feet, proper wound debridement, ideal dressings and lower limb revascularization procedures doctors at AIMS have been able to maintain a limb salvage rate of 91.5%, which is comparable to the best centres in the world. AIMS also boasts to be the only centre in India where foot and ankle reconstructive surgeries are being performed routinely in large numbers, in exclusively high-risk Diabetic foot patients. The institute, through extensive research, has also been able to synthesize a new material for diabetic footwear. This is superior to the presently available diabetic footwear anywhere in the world.
Diabetes is a disease of the blood vessels. By the time the lower limb has vascular obstruction, the heart is already affected by poor blood supply. If a diabetic patient, who has undergone a major amputation, is ambulant on prosthesis, there is increased cardiac strain to the rate of 15%. Thus by limb salvage it is not only the quality of life/ psychological status of the patients that is improved, but even the life span is increased. In developing countries, the major amputation rate in diabetic foot wounds is about 45% and about 8.7% in western countries. At AIMS, the combined team effort of the doctors to salvage the limbs has brought down this rate to 8.5%.
The conference was inaugurated by a lamp lighting ceremony on 6th May by Sampoojya Swamiji Poornamritanandapuri, a senior Swami of Mata Amritanandamayi Math. In his address to the audience, he stressed on the importance of spirituality in day to day life, especially in the medical profession. He impressed on the delegates to have empathy and compassion while dealing with patients. The chief guest for the conference was Professor (Dr.) Ramakant, President, Associations of surgeons of India, who highlighted the problem of diabetic foot in India and the contribution of Amrita Institute of Medical Sciences, in this regard. He talked of some interesting surgical issues in diabetic foot management.
The scientific sessions on the first day of the conferencecommenced with a key note address by podiatric surgeon from the U.S. Dr. Sarnarendra Miranpuri, He spoke on ‘The Multidisciplinary Approach to Diabetic Limb Salvage’. He stressed on the importance of reconstructive foot and ankle surgeries in limb salvage, and amputation prevention in diabetic patients. Other talks of the day included Lower limb osteomyelitis and long term intravenous antibiotic therapy, various modalities for soft tissue and bone debridement, prevalence of Fungal Infection of Deep Tissues of Lower-Limb Wounds, nutritional assessment and management, radiological investigations, skin grafts, endovascular therapy for dysvascular diabetic foot, Continuous Glucose Monitoring System, Advanced Management of the High Risk Diabetic Foot, and Cardiovascular risk and hyper glycemia management in Diabetes Mellitus.
The second day of the conference started with a session on few excellent talks on Role of Microvascular Surgery in reconstruction of diabetic foot wounds, Chronic Diabetic foot wounds and the importance of Tissue Oxygenation Assessment. This was followed by a session on free paper
presentation-- both oral and posters-- where about 18 delegates presented their research studies. Dr Shibin T Sudevan, Department of Endocrinology and Podiatric Surgery, AIMS, was awarded the first prize for his study 'Bacteriological profile of diabetic foot infections' making a clear conclusion: judicious use of antibiotics will decide the treatment outcome of diabetic foot infections. Next there was an extremely informative session of video demonstrations of foot and ankle reconstructive surgeries on diabetic patients, carried out by our Podiatric guest faculty surgeons from the U.S. These were severely deformed and destroyed Charcot’s ankle and foot cases. In the absence of these limb salvaging surgeries, the patients would have to be subjected to a below knee amputation There were also video demonstrations of peripheral bypass surgeries and a video on the method of proper debridement in infected diabetic lower limb wounds.
The closing address was given by Dr.Ajith Kumar Verma, who thanked the entire faculty, delegates, sponsors, and supporting staff. He also invited all the delegates to make it possible to attend the next edition of the conference in first week of May 2012, at the same venue.
So Au Revoir till then.
Shobha Shukla - CNS
(The author is the Editor of Citizen News Service (CNS). She is a J2J Fellow of National Press Foundation (NPF) USA. She has worked earlier with State Planning Institute, UP. Email: shobha@citizen-news.org, website: http://www.citizen-news.org)
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