Link to Owner Dr. Robert B. Pamplin Jr.



COURTESY OF ADVENTIST MEDICAL CENTER - Patients at risk of losing a limb may spend 90 minutes to two hours in a chamber filled with pure oxygen, which can help patients fend off infections and improve wound healing. Adventist Health’s Limb Preservation Team, the only program of its kind in Portland, is pioneering in a mission to save limbs.

Advancements in medicine are preventing the loss of limbs and the physical and emotional devastation that accompanies such a loss.

The limb preservation team, part of the hospital’s Wound Healing and Hyperbaric Medicine program, addresses the patient’s entire medical needs and lifestyle before beginning treatment or recommending amputation.

It’s a unique, multidisciplinary approach to limb preservation.

Each patient has a team of experts working to save the limb, including specialists in vascular, orthopedics, diabetes, wound care and primary care who monitor the patient and review all components of the treatment plan.

“Our program offers patients an alternative treatment method before amputation. We are more in favor of an aggressive interventional approach to re-establish the healing potential of the patient,” says Dr. Enoch Huang, a hyperbaric medicine specialist at Adventist Health. “We consider the whole patient and try less invasive healing strategies first, like improving nutrition and increasing exercise, and supplement those changes with hyperbarics to see if we can improve circulation and ultimately save someone’s limb.”

With a team approach to health care combined with hyperbaric medicine, Adventist Health’s physicians work to improve oxygenation and circulation in the feet or non-healing wounds.

Patients at risk of losing a limb are sealed in a pressurized chamber for 90- to 120-minute sessions and 100 percent pure oxygen is pumped into the chamber. This increases oxygen in the patient’s bloodstream, tissues and cells, which helps treat infections and improve wound healing. The pressure inside a hyperbaric chamber for a typical treatment is equivalent to the pressure found at about 45 feet below sea level.

Adventist Health’s program has partly been so successful because of LUNA fluorescence angiography, a near-infrared laser-based technology that allows the limb preservation team to quickly examine circulation in the body using tracking dyes injected into the blood stream. Adventist Medical Center in southeast Portland is the only hospital in Oregon with this technology.

The limb preservation team can be a crucial resource for people living with diabetes I or II. Most patients needing limb preservation care are people living with diabetes who have poor circulation and low levels of oxygen in their wounds. The smallest blister, cut or sore can be extremely dangerous and put a limb in jeopardy.

The combination of neuropathy and poor circulation leads to decreased healing potential. Bacteria thrive in poorly oxygenated environments, making people living with diabetes more susceptible to infection and amputation. Approximately 287,000 adult Oregonians have been diagnosed with diabetes and an estimated 110,000 more don’t know that they have it.

In Oregon, diabetes is more common among men compared to women (9.2 percent vs. 7.8 percent). A correlation could be made to amputation rates.

Sixty percent of Adventist Health’s limb preservation patients are men, a significant disproportion to women. Dr. Huang’s team believes it’s because women typically seek medical attention sooner than men, and when some patients finally seek help, the infection is too far advanced for treatment. For the limb preservation team, every minute counts when saving a patient’s toes, foot or hand.

One of the first symptoms that would alert someone they might be at risk is numbness or tingling in the hands and feet. The toes, feet and fingers are the first limbs to go numb, which happens when neuropathy sets in because nerves die due to the effects of diabetes. Another effect of diabetes is the destruction of small blood vessels called capillaries. This decreases blood flow, causing limbs to become compromised.

Dr. Huang and his team stress that people should exercise regularly, eat a healthy diet and quit smoking. Poor lifestyle choices can lead to diabetes and a number of chronic diseases, including obesity and heart disease.

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