Latest figures from Lautoka Aspen Hospital show a dramatic fall in amputations as intensified limb-salvage work begins to pay off, hospital vascular consultant Dr Ronal Kumar told a Fiji Medical Association mini-conference in Nadi on Saturday. He said the facility has cut operations that once averaged two to three amputations per day to about two per week, bringing monthly totals down from around 20–30 to roughly six to ten.
Dr Kumar attributed the improvement to an aggressive strategy that prioritises early intervention, restoring blood supply and modern wound management techniques. Innovations such as vacuum‑assisted closure (VAC) dressings are being used to debride and promote healing, reducing the need for limb removal in many cases. As a tertiary referral centre for the Western Division, Lautoka Aspen still sees complex, advanced cases, making each limb-salvage success an important win.
A persistent workforce gap is slowing progress, however. Dr Kumar identified the absence of specialised wound care nurses in Fiji as a critical shortfall. “Once we have dedicated wound care nurses, surgeons can concentrate more on limb salvage and improving blood flow, rather than routine dressing and wound management,” he said, calling the roles vital to sustaining and expanding current gains.
Late presentation remains the major obstacle. Dr Kumar estimated that 75–80 percent of patients arrive at the hospital with late-stage disease, by which point effective salvage is far more difficult. He blamed several factors for delays: failures or slow referral at the primary health‑care level, reliance on herbal or traditional remedies, and geographic isolation that limits access to timely care.
Perceptions of hospitals also discourage early attendance. Dr Kumar warned that many people still believe hospital admission inevitably leads to amputation, a view that deters early presentation. “What we’re trying to get out is that if you present early, then we are in a state to save the foot,” he said, stressing prevention and education as key components of reducing amputations further.
For those who do undergo amputation, the pathway to restored mobility is uneven. Prosthetic services are available at no cost in Suva, but Dr Kumar noted not all amputees are candidates for prostheses, and social and geographic barriers—distance from centres offering prosthetic fitting, transport difficulties, and socioeconomic constraints—often block access to rehabilitation and community reintegration.
The latest figures from Lautoka Aspen mark a clear shift in surgical outcomes for limb-threatening disease in Fiji’s western region, demonstrating that targeted clinical interventions and modern wound care can reduce amputations substantially. Still, the gains underline the need for broader health-system changes: strengthening primary care and referral networks, deploying specialised wound-care nurses, and public education to encourage earlier hospital presentation if further reductions in amputation rates are to be sustained.
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