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Minor amputation in patients with diabetes mellitus and severe foot ulcers achieves good outcomes.

Örneholm, Hedvig LU ; Apelqvist, Jan LU ; Larsson, J; Lindholm, Eero LU and Eneroth, Magnus LU (2011) In Journal of wound care 20(6). p.261-261
Abstract
OBJECTIVE:

To analyse the outcome of minor amputations (through, or distal to, the ankle joint) in patients with diabetes.



METHOD:

All diabetic patients in a defined population undergoing one or more minor amputation between 1982 and 2006 were investigated according to a standardised protocol and were followed until final outcome (healing or death). A total of 410 consecutive amputations in 309 patients with a median age of 73 (32-93) years were identified.



RESULTS:

In 94% of amputations, deep infection (39%) and/or gangrene (55%) was present. Severe peripheral vascular disease or critical limb ischaemia was present in 61% of amputations. 261/410 (64%) of the amputations... (More)
OBJECTIVE:

To analyse the outcome of minor amputations (through, or distal to, the ankle joint) in patients with diabetes.



METHOD:

All diabetic patients in a defined population undergoing one or more minor amputation between 1982 and 2006 were investigated according to a standardised protocol and were followed until final outcome (healing or death). A total of 410 consecutive amputations in 309 patients with a median age of 73 (32-93) years were identified.



RESULTS:

In 94% of amputations, deep infection (39%) and/or gangrene (55%) was present. Severe peripheral vascular disease or critical limb ischaemia was present in 61% of amputations. 261/410 (64%) of the amputations healed at a level below the ankle joint; 69/410 (17%) healed after a re-amputation above the ankle joint; in 76/410 of amputations (19%), the patient died before healing could occur. In surviving patients, 79% of the amputations healed below the ankle. Median healing time for amputations that healed below the ankle was 26 (2-250) weeks; 21% of amputations required a re-amputation above the ankle. None of the analysed parameters excluded the possibility of healing below the ankle.



CONCLUSION:

In this population-based survey, the goal of avoiding major amputation was achieved in almost two thirds of minor amputations, but at the price of long healing times. In almost all amputations, the patient had deep infection and/or gangrene. In spite of this, 64% of all amputations, and 79% of amputations in surviving patients, healed at a level below the ankle. This indicates that minor amputations in these patients are worthwhile.



DECLARATION OF INTEREST:

None (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of wound care
volume
20
issue
6
pages
261 - 261
publisher
Emap Healthcare Limited
external identifiers
  • WOS:000303103100002
  • PMID:21727875
  • Scopus:79958776147
ISSN
0969-0700
language
English
LU publication?
yes
id
50e9373b-78d4-45ae-9ce8-27ff0cf84721 (old id 2058992)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21727875?dopt=Abstract
date added to LUP
2011-08-01 19:13:47
date last changed
2016-10-13 04:31:43
@misc{50e9373b-78d4-45ae-9ce8-27ff0cf84721,
  abstract     = {OBJECTIVE:<br/><br>
To analyse the outcome of minor amputations (through, or distal to, the ankle joint) in patients with diabetes.<br/><br>
<br/><br>
METHOD:<br/><br>
All diabetic patients in a defined population undergoing one or more minor amputation between 1982 and 2006 were investigated according to a standardised protocol and were followed until final outcome (healing or death). A total of 410 consecutive amputations in 309 patients with a median age of 73 (32-93) years were identified.<br/><br>
<br/><br>
RESULTS:<br/><br>
In 94% of amputations, deep infection (39%) and/or gangrene (55%) was present. Severe peripheral vascular disease or critical limb ischaemia was present in 61% of amputations. 261/410 (64%) of the amputations healed at a level below the ankle joint; 69/410 (17%) healed after a re-amputation above the ankle joint; in 76/410 of amputations (19%), the patient died before healing could occur. In surviving patients, 79% of the amputations healed below the ankle. Median healing time for amputations that healed below the ankle was 26 (2-250) weeks; 21% of amputations required a re-amputation above the ankle. None of the analysed parameters excluded the possibility of healing below the ankle.<br/><br>
<br/><br>
CONCLUSION:<br/><br>
In this population-based survey, the goal of avoiding major amputation was achieved in almost two thirds of minor amputations, but at the price of long healing times. In almost all amputations, the patient had deep infection and/or gangrene. In spite of this, 64% of all amputations, and 79% of amputations in surviving patients, healed at a level below the ankle. This indicates that minor amputations in these patients are worthwhile.<br/><br>
<br/><br>
DECLARATION OF INTEREST:<br/><br>
None},
  author       = {Örneholm, Hedvig and Apelqvist, Jan and Larsson, J and Lindholm, Eero and Eneroth, Magnus},
  issn         = {0969-0700},
  language     = {eng},
  number       = {6},
  pages        = {261--261},
  publisher    = {ARRAY(0xa471e08)},
  series       = {Journal of wound care},
  title        = {Minor amputation in patients with diabetes mellitus and severe foot ulcers achieves good outcomes.},
  volume       = {20},
  year         = {2011},
}