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Septic diabetic foot is not necessarily an indication for amputation
Abolfazl Shojaiefard1, Zhamak Khorgami, Bagher Larijani
1Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. shojaief@sina.tums.ac.ir
Summary
Aggressive management of the septic diabetic foot, including glucose control and surgical care, can prevent amputation. This study shows limb salvage is achievable with a comprehensive treatment protocol.
Area of Science:
- Diabetic foot complications
- Infectious disease management
- Surgical outcomes
Background:
- Septic foot in diabetic patients often leads to amputation.
- Effective management strategies are crucial for limb salvage.
Purpose of the Study:
- To evaluate a comprehensive protocol for managing septic diabetic foot.
- To determine the efficacy of the protocol in limb salvage versus amputation.
Main Methods:
- A protocol involving glucose control, antibiotics, comorbidity management, revascularization, ulcer care, and debridement was followed.
- Data from 31 septic feet in 139 patients over 2 years were analyzed.
Main Results:
- The protocol resulted in a limb salvage rate of 87.1% (24 out of 31 feet).
- Only 4 major and 3 transmetatarsal amputations were performed.
- Amputations were associated with ischemia and/or neuropathy.
Conclusions:
- Septic diabetic foot does not always necessitate amputation.
- Aggressive metabolic and surgical management can achieve favorable outcomes and limb salvage.
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