Timely surgery helps man avoid second amputation

The Mandeville Regional Hospital (MRH) has successfully performed a complex bypass procedure, saving a patient’s only remaining lower limb from amputation.

Dr Varunesh Chand, consultant general surgeon at MRH, said 72-year-old Edwin Rowe was admitted in April 2026 with chronic limb-threatening ischaemia, presenting as gangrene in his fourth toe — a condition caused by inadequate blood supply leading to tissue death.

Rowe’s right leg faced a high risk of amputation due to peripheral arterial disease and severely reduced blood flow, linked to long-term diabetes, hypertension and a history of smoking.

“Four years earlier, Mr Rowe underwent a left below-knee amputation due to infectious complications related to diabetes. Despite this setback, he remained functional and independent. With his right leg now solely responsible for mobility and balance, it was considered his ‘precious limb,’ and its loss would result in permanent wheelchair dependence,” Dr Chand noted.

A CT scan revealed extensive arterial blockages from the main thigh artery into the lower leg and foot. Only a small segment of the healthy artery below the ankle remained suitable for surgery, and endovascular stenting was not an option.

The surgical team instead performed an inframalleolar bypass, a specialised procedure that redirects blood flow around blocked arteries. A segment of the patient’s saphenous vein was harvested and used as a graft to restore circulation to the foot.

Post-operative scans showed more than a 50 per cent improvement in blood flow. Rowe recovered smoothly and was later discharged.

With circulation restored, the immediate threat of amputation was removed, allowing him to retain mobility, independence and quality of life.

The procedure was carried out on May 20.