Chandigarh: PGI launches India’s first ‘amputee clinic’

THE PGIMER on Monday launched its ‘PGI Amputee Clinic’, the first in India. The clinic, a collective effort of various experts and departments of the institute, strives to provide social, mental and physical support to its patients.

PGIMER Director Prof. Jagat Ram formally inaugurated the clinic, which is being set up to improve amputation patient care by providing a host of services under one roof and with significant coordination. “The basic intent of this initiative is to send the amputee as a near normal functional human being to society.”

The Amputee Clinic, he added, would attempt to unify all diverse sections in PGIMER, with some upgradations where needed, to provide appropriate management to amputees to guide them in their path to rehabilitation in society. “Some modalities would be worked out under the initiative to extend financial support for the medical as well as rehabilitation of amputees who cannot afford the cost,” added Prof. Ram.

Prof. M S Dhillon, head, department of orthopaedics, who spearheaded the initiative, said, “This is the first of its kind clinic in the country and no such clinic exists elsewhere. Over the last few years, it has been our endeavour to provide comprehensive care to post-trauma amputees, with various aspects of multidisciplinary care. For the last 1.5 years, we have combined all the specialities that help in patient care and rehab under one roof; we now have formalized this as PGI Amputee Clinic, comprising specialists from various departments i.e. orthopaedics, PMR (Physical and Medical Rehabilitation), occupational/ physiotherapy, prosthetists, psychologists and nursing department, who had already been providing care, but as individual entities.”

Prof. Dhillon added that during the pilot project, out of 3,047 trauma patients, as many as 125 needed amputation and one of the major causes was that the patient was referred to PGI very late and that’s why to save their life, the amputation had to be done. According to a study titled, ‘Focused Amputee Clinics: The need of the hour’, published in the Indian Journal of Orthopaedics, accidents, complications of diabetes, and peripheral vascular disease are some commonly reported indications. The need of such clinics, elaborates the paper, is to assess the recovery and co-morbidities of patients who undergo amputation, with a team of occupational therapists and a psychologist who become involved in patient care immediately. Further multidisciplinary management included prosthesis fitting and long-term care of prosthesis, along with stump care looked after by orthopaedic surgeons. Such clinics, states the paper, can be instrumental in providing holistic care to the patients under one roof, so that the patient is not forced to fall out of the rehabilitation process because of stress and anxiety.

Additional benefits would be the development of a comprehensive database, which not only provides a platform for future research but also more significantly gives essential information about the burden, long-term complications and rehabilitation issues of these amputees. Amputee clinics also offer a forum for these patients where they can bring their problems and discuss with the team as dedicated time slots are provided to the patients. There is also the additional benefit of patient-to-patient bonding, which shows these people that they are not alone, as they see other similar cases and relate to them, with a boost to recovery after seeing rehabilitated cases.

Prof. Dhillon further shared, “It is an upcoming concept to provide holistic care to patients with amputation. It involves evaluation, resuscitation and treatment after the initial event (usually trauma), followed by appropriate planning and surgical interventions. The concept of the amputee clinic involves a journey proceeding from initial trauma through surgical recovery, which included physiotherapy and occupational training, fabrication and appropriate fitting of prosthesis, till the potential return of the amputee to as normal a lifestyle as possible. In the current age of super specialisation, every facet of treatment is best managed by specialised personnel. However, providing comprehensive care to amputees is a neglected area in our country. We recently had raised our concerns regarding the same previously. We will coordinate with the governments of Punjab, Haryana and Himachal to provide prosthesis to those who cannot afford and will share these details with the patients. The clinic will also provide us with comprehensive patient data and documentation. Surprisingly, except for two studies from PGI, no amputee data from India has been available for the last 30 years.” As part of the initiative, the clinic will also run ‘Amputee Schools’ on the basis of the successful ‘Knee School’ being run at PGI.