Impact of Timing of Minor Amputations After Revascularization on Patient Outcomes

Vascular complications from diabetes contribute significantly to major and minor limb amputations. Diabetes is a major health burden in Saudi Arabia, with increased incidence in rural areas. The purpose of this study was to evaluate the timing of minor lower limb amputations after revascularization and their relative outcomes.

This was a retrospective study done in Prince Sultan Military Medical City, Riyadh, Saudi Arabia. Patients who underwent minor lower limb amputation after revascularization during 2018-2022 were included in the study.

Of the 90 patients who were eligible for the study, 83 (94%) were diabetic, and 66 (73%) underwent revascularization. The timing between revascularization and amputation varied, with 34 (37.8%) amputations occurring on the same day as revascularization, 17 (18.9%) occurring within seven days of revascularization, and 39 (43.3%) occurring more than seven days post-revascularization. No significant differences in amputation (p=0.105) were observed based on the timing of amputation after revascularization. Diabetic patients showed significantly higher rates of wound infection (p=0.028) and longer healing times (p=0.000). Finally, diabetic patients were more likely to have healing times of more than 60 days (25.9%) compared to non-diabetic patients (20.0%).

Based on our results, the timing of endovascular or surgical repair did not affect patient outcomes. Moreover, diabetes was found to be a prognostic factor for poor wound healing and infection.