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Lower limb amputation for diabetic foot.

S Ohsawa1, Y Inamori, K Fukuda

  • 1Department of Rehabilitation Medicine, Osaka Rosai Hospital, 1179-3, Nagasone-Cho, Sakai-City, Osaka, 591-8025, Japan. sohsawa@orh.go.jp

Archives of Orthopaedic and Trauma Surgery
|April 25, 2001
PubMed
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Diabetic foot amputations require careful level selection. Factors like lower site temperature, female sex, and older age increase reamputation risk, highlighting skin thermography

Area of Science:

  • Podiatric Surgery
  • Diabetology
  • Vascular Surgery

Background:

  • Diabetic foot infections and complications often necessitate limb amputation.
  • Patients referred for amputation typically have failed conservative treatments.
  • Comorbidities like neuropathy, nephropathy, and arteriosclerosis are prevalent in diabetic foot patients.

Purpose of the Study:

  • To analyze amputation levels and identify risk factors for reamputation in diabetic foot patients.
  • To evaluate the effectiveness of skin thermography in determining optimal amputation levels.
  • To assess outcomes and mortality following lower limb amputations for diabetic foot complications.

Main Methods:

  • Retrospective analysis of 35 lower limb amputations in 27 patients with diabetic foot from 1988-1998.

Related Experiment Videos

  • Classification of foot conditions using the Wagner system.
  • Determination of amputation level influenced by skin thermography and patient preference.
  • Logistic regression analysis to identify risk factors for reamputation.

    • Main Results:

    • 15 out of 35 initial amputations (43%) required upper level reamputation.
    • Significant risk factors for reamputation included lower amputation site temperature, female gender, and advanced age.
    • Skin thermography was utilized to guide amputation level selection, aiming to minimize reamputation.

    Conclusions:

    • Careful selection of amputation level, guided by methods like skin thermography, is crucial for reducing reamputation rates in diabetic foot patients.
    • Identifying and mitigating risk factors such as low site temperature, female sex, and older age can improve surgical outcomes.
    • Diabetic foot amputations carry a significant mortality risk, underscoring the importance of effective preventative and surgical strategies.