Bypass

What you should know about Bypass?

What Is A Bypass?

A bypass, particularly in the context of leg arteries, involves surgically creating a detour around a blocked or narrowed artery to restore proper blood flow to the legs. 

During the procedure, a healthy blood vessel, often from another part of the body or a synthetic graft, is used to reroute blood past the obstructed area. This helps to alleviate symptoms such as pain, cramping, and difficulty walking, ultimately improving circulation to the legs. 

Leg bypass surgery is typically recommended for individuals with severe peripheral artery disease (PAD) who have not responded to other treatments and are at risk of complications such as tissue damage or amputation due to reduced blood flow.

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When Is A Bypass Necessary?

Leg bypass surgery, due to its invasive nature, is usually a last resort in the most extreme cases of diabetic foot disease. Such individuals have minimal circulation to the feet, a high risk of infection or amputation, and persistent diabetic foot ulcers. 

An angioplasty is first recommended but if poor blood flow still persists or if the angioplasty procedure fails, a bypass is the next option. Certain individuals may not be suitable for an angioplasty and in such cases, a bypass will be recommended.

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Benefits Of A Bypass

A bypass plays a crucial role in preventing complications such as persistent infection and the need for amputation, promoting better long-term outcomes for patients. Some of its benefits include: 

Improved Blood Flow: Leg bypass surgery enhances blood circulation in the affected limbs, ensuring an adequate supply of oxygen and nutrients to the tissues, which is vital for healing and maintaining tissue viability.

Limb Salvage: The procedure can prevent the progression of critical limb ischemia, reducing the risk of limb amputation and its associated psychological and physical challenges.

Wound Healing: Enhanced blood circulation supports the healing of ulcers and wounds commonly associated with diabetic foot, reducing the risk of infections and further complications.

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What To Expect During A Bypass

Pre-Surgery Scan: You will undergo a scan to determine the location and extent of the blockage. Often, this is done with an ultrasound scan or via the injection of an x-ray dye into the veins.

Surgical Procedure: During the surgery, the surgeon will place the graft above and below the extent of the blockage to ensure a successful outcome. The graft is either made from synthetic tubing or a blood vessel transplanted from elsewhere in your body.

Graft Placement: The surgeon will make a small incision over the blocked blood vessel and clamp both ends. The graft is then sewn into place before the surgeon resumes blood flow. If the graft works, the surgeon sews up the initial incision.

Bypass Recovery

After undergoing bypass surgery for a diabetic foot ulcer, the recovery process typically takes several weeks to months. During this time, it's crucial to follow your doctor's instructions closely to ensure a smooth recovery. This may include keeping the incision site clean and dry, taking prescribed medications as directed, and attending follow-up appointments. 

Additionally, you should gradually increase your activity level as advised by your healthcare provider, with most patients being able to resume light exercise within a few weeks post-surgery. By adhering to these guidelines and maintaining a healthy lifestyle, you can optimise your recovery and reduce the risk of complications.

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Complications of a Bypass

Understanding the potential complications associated with bypass surgery can help you with informed decision-making and proactive management of post-operative care.

Infection: Signs of infection at the surgical site include redness, swelling, warmth, or discharge. 

Bleeding: Excessive bleeding at the surgical site that doesn't stop with standard first aid measures warrants immediate medical attention.

Blood Clots: Symptoms like new or worsening swelling, pain in the leg, or changes in skin colour (redness) should prompt an urgent visit to the doctor.

Graft Failure: Decreased temperature in the limb, changes in skin colour, or a decrease in pulse below the surgery site can indicate graft failure.

Nerve Damage: Persistent or worsening numbness, tingling, or pain could signal nerve damage. 

Heart Problems: New or worsening chest pain, difficulty breathing, or irregular heartbeat post-surgery can indicate heart-related complications.

If you experience any of these symptoms or if there's something unusual or concerning during your recovery, speak to a medical professional. Additionally, sudden shortness of breath or leg pain is another major concern.

Dr Desmond Ooi: Bypass Surgery for Diabetic Foot Wounds in Singapore

Dr. Desmond Ooi provides bypass surgeries for diabetic foot ulcers, leveraging his expertise and commitment to deliver personalised care and support to every patient. Schedule an appointment with Dr Desmond Ooi for tailored treatment and comprehensive care for diabetic foot ulcers.