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A developing world experience with distal foot amputations for diabetic limb salvage
Omer Salahuddin1, Muhammad Azhar, Aqsa Imtiaz
1Department of Plastic Surgery, Shifa International Hospital, Islamabad, Pakistan.
Diabetic Foot & Ankle
|October 25, 2013
Summary
Diabetic foot salvage is achievable with early surgical intervention, good glycemic control, and diligent foot care. This approach can significantly reduce amputations in patients with diabetes mellitus.
Area of Science:
- Diabetic foot complications
- Surgical management of diabetic foot ulcers
- Limb salvage surgery
Background:
- Diabetes mellitus (DM) poses a significant risk for foot ulcers and subsequent amputations.
- The rising prevalence of DM necessitates effective strategies for diabetic foot salvage.
Purpose of the Study:
- To assess the functional outcomes, morbidity, and success rates of foot salvage procedures in diabetic patients.
- To identify key factors influencing the viability of limb salvage in this population.
Main Methods:
- A prospective case series involving 149 diabetic patients (171 amputations) over five years.
- Management included wound debridement, antibiotic therapy, and meticulous wound care.
- Surgical interventions ranged from partial toe amputations to transmetatarsal amputations.
Main Results:
- Staphylococcus aureus was the most common pathogen (46%).
- Most amputations were partial toe or hallux procedures; 19 required revision.
- Thirty-nine patients died, primarily due to systemic complications (36 deaths).
Conclusions:
- Early surgical intervention, combined with strict glycemic control and comprehensive foot care, is crucial for successful diabetic foot salvage.
- Effective management can decrease the rate of lower-extremity amputations in diabetic patients.
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