A comparison of diabetics and nondiabetics with threatened limb loss

One hundred seventeen patients with threatened limb loss were evaluated. Seventy-three of these patients underwent vascular reconstruction. Diabetics had a significantly higher incidence of ischemic ulceration and gangrene when compared with nondiabetics. Nondiabetics typically presented with rest pain. The outcome of foot salvage surgery was evaluated by postoperative ankle-branchial indices as well as limb salvage rates. Ankle-brachial indices increased significantly in both groups. Fifty-five percent of the diabetics and 67 percent of the nondiabetics had a postoperative ankle-brachial index of 0.8 or greater. Overall foot salvage at 1 year was 84 percent. Foot salvage in patients with diabetes was 78 percent compared with 86 percent in nondiabetics. In this subset of patients with threatened limb loss confirmed by hemodynamic measurements, the results of vascular reconstruction were comparable in both diabetic and nondiabetic patients.