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Eero Lindholm

Associate professor

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Minor amputation in patients with diabetes mellitus and severe foot ulcers achieves good outcomes.

Author

  • Hedvig Örneholm
  • Jan Apelqvist
  • J Larsson
  • Eero Lindholm
  • Magnus Eneroth

Summary, in English

OBJECTIVE:

To analyse the outcome of minor amputations (through, or distal to, the ankle joint) in patients with diabetes.



METHOD:

All diabetic patients in a defined population undergoing one or more minor amputation between 1982 and 2006 were investigated according to a standardised protocol and were followed until final outcome (healing or death). A total of 410 consecutive amputations in 309 patients with a median age of 73 (32-93) years were identified.



RESULTS:

In 94% of amputations, deep infection (39%) and/or gangrene (55%) was present. Severe peripheral vascular disease or critical limb ischaemia was present in 61% of amputations. 261/410 (64%) of the amputations healed at a level below the ankle joint; 69/410 (17%) healed after a re-amputation above the ankle joint; in 76/410 of amputations (19%), the patient died before healing could occur. In surviving patients, 79% of the amputations healed below the ankle. Median healing time for amputations that healed below the ankle was 26 (2-250) weeks; 21% of amputations required a re-amputation above the ankle. None of the analysed parameters excluded the possibility of healing below the ankle.



CONCLUSION:

In this population-based survey, the goal of avoiding major amputation was achieved in almost two thirds of minor amputations, but at the price of long healing times. In almost all amputations, the patient had deep infection and/or gangrene. In spite of this, 64% of all amputations, and 79% of amputations in surviving patients, healed at a level below the ankle. This indicates that minor amputations in these patients are worthwhile.



DECLARATION OF INTEREST:

None

Department/s

  • Orthopedics - Clinical and Molecular Osteoporosis Research
  • Genomics, Diabetes and Endocrinology
  • Orthopaedics (Lund)
  • EXODIAB: Excellence in Diabetes Research in Sweden

Publishing year

2011

Language

English

Pages

261-261

Publication/Series

Journal of Wound Care

Volume

20

Issue

6

Document type

Journal article

Publisher

Emap Healthcare Limited

Topic

  • Orthopedics

Status

Published

Research group

  • Orthopedics - Clinical and Molecular Osteoporosis Research
  • Genomics, Diabetes and Endocrinology

ISBN/ISSN/Other

  • ISSN: 0969-0700