Bone Marrow Exposure during Minor Amputation for Diabetic Foot Gangrene: A Single-Center Retrospective Study

Area of Science:

• Podiatry
• Diabetology
• Surgical Oncology

Background:

• The incidence of diabetic gangrene is rising due to increased longevity in diabetic patients.
• Diabetic foot complications pose a significant health challenge.

Purpose of the Study:

• To evaluate the efficacy of minor amputation with bone marrow exposure for diabetic foot gangrene.
• To identify predictors of recurrence and the number of operations required.

Main Methods:

• Retrospective analysis of 27 Japanese adult patients with diabetic foot gangrene.
• Surgical excision of affected tissues, including bone, with amputation at the toe or metatarsal level.
• Adequate exposure of bone marrow during surgical procedures.

Main Results:

• High healing rate (96.3%) with satisfactory outcomes in 26 out of 27 patients.
• Recurrence observed in 14.8% of patients; 3.7% required reconstructive surgery.
• Elevated white blood cell (WBC) count and C-reactive protein (CRP) levels were significantly associated with recurrence and increased number of operations.

Conclusions:

• Minor amputation with bone marrow exposure is a simple and effective treatment for diabetic foot gangrene.
• Higher WBC and CRP levels may serve as predictive markers for recurrence and the need for multiple operations.
• This therapeutic approach offers a promising solution for managing diabetic foot gangrene.