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Improved results with diabetic below-knee amputations.

J Fearon, D R Campbell, C S Hoar

    Archives of Surgery (Chicago, Ill. : 1960)
    |July 1, 1985
    PubMed
    Summary
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    Diabetic patients undergoing below-knee amputation showed improved outcomes due to aggressive infection control and close follow-up. Successful below-knee amputations increased significantly compared to a previous study.

    Area of Science:

    • Vascular Surgery
    • Diabetic Limb Salvage
    • Infectious Disease Management

    Background:

    • Below-knee amputations are common in diabetic patients, often complicated by ischemia and infection.
    • Previous studies highlight challenges in managing diabetic lower extremity amputations.

    Purpose of the Study:

    • To review outcomes of below-knee amputations in diabetic patients.
    • To compare current results with data from 20 years prior.
    • To identify factors contributing to successful amputation outcomes.

    Main Methods:

    • Retrospective review of 100 consecutive below-knee amputations in 98 diabetic patients.
    • Analysis of patient demographics, comorbidities, surgical procedures, and outcomes.
    • Comparison with a historical cohort from two decades ago.

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    Main Results:

    • 93% of limbs were ischemic; 79% had significant infection.
    • Mortality rate was 3%; wound complication rate was 18%.
    • 83% of patients achieved ambulatory status at discharge (average 35 days).
    • Significant improvement in successful below-knee amputations compared to the previous study.

    Conclusions:

    • Aggressive surgical control of infection is crucial for successful diabetic amputations.
    • Close follow-up and early management of healing problems improve outcomes.
    • Current below-knee amputation success rates in diabetic patients have significantly improved.