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Local signs and symptoms in relation to final amputation level in diabetic patients. A prospective study of 187 patients with foot ulcers

Larsson, Jan; Agardh, Carl-David LU ; Apelqvist, Jan LU and Stenström, Anders LU (1994) In Acta Orthopaedica Scandinavica 65(4). p.387-393
Abstract
Local signs and symptoms were evaluated in 187 consecutively presenting diabetic patients undergoing amputation for foot ulcers. From admission until final outcome the patients were treated by the same multidisciplinary team both as in- and out-patients. At the time of amputation, the types of lesions were superficial/deep ulcer (n 17), ulcer with deep infection, but without gangrene (n 40), and gangrene with or without infection (n 130). Healing after a minor amputation (below the ankle) occurred in 74 patients, while 88 patients healed after a major amputation (above the ankle), and 25 patients died before healing had occurred. Deep infection and presence of popliteal or pedal pulses were associated with healing after minor amputation... (More)
Local signs and symptoms were evaluated in 187 consecutively presenting diabetic patients undergoing amputation for foot ulcers. From admission until final outcome the patients were treated by the same multidisciplinary team both as in- and out-patients. At the time of amputation, the types of lesions were superficial/deep ulcer (n 17), ulcer with deep infection, but without gangrene (n 40), and gangrene with or without infection (n 130). Healing after a minor amputation (below the ankle) occurred in 74 patients, while 88 patients healed after a major amputation (above the ankle), and 25 patients died before healing had occurred. Deep infection and presence of popliteal or pedal pulses were associated with healing after minor amputation and so were ulcers on the small toes, metatarsal head area and midfoot. Pain, progressive gangrene, intermittent claudication, and decubital and multiple ulcers were related to healing after major amputation. In a logistic regression analysis, pain, progressive gangrene and intermittent claudication remained. However, none of these factors excluded healing of a minor amputation and thus selection of amputation level in diabetic patients with foot ulcers cannot be based upon these factors exclusively. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica Scandinavica
volume
65
issue
4
pages
387 - 393
publisher
Taylor & Francis
external identifiers
  • pmid:7976281
  • scopus:0028130719
ISSN
0001-6470
DOI
10.3109/17453679408995476
language
English
LU publication?
yes
id
af92c0c1-e855-4f3d-962c-552a1ce5db38 (old id 1108028)
date added to LUP
2008-07-23 11:32:16
date last changed
2017-07-23 04:30:41
@article{af92c0c1-e855-4f3d-962c-552a1ce5db38,
  abstract     = {Local signs and symptoms were evaluated in 187 consecutively presenting diabetic patients undergoing amputation for foot ulcers. From admission until final outcome the patients were treated by the same multidisciplinary team both as in- and out-patients. At the time of amputation, the types of lesions were superficial/deep ulcer (n 17), ulcer with deep infection, but without gangrene (n 40), and gangrene with or without infection (n 130). Healing after a minor amputation (below the ankle) occurred in 74 patients, while 88 patients healed after a major amputation (above the ankle), and 25 patients died before healing had occurred. Deep infection and presence of popliteal or pedal pulses were associated with healing after minor amputation and so were ulcers on the small toes, metatarsal head area and midfoot. Pain, progressive gangrene, intermittent claudication, and decubital and multiple ulcers were related to healing after major amputation. In a logistic regression analysis, pain, progressive gangrene and intermittent claudication remained. However, none of these factors excluded healing of a minor amputation and thus selection of amputation level in diabetic patients with foot ulcers cannot be based upon these factors exclusively.},
  author       = {Larsson, Jan and Agardh, Carl-David and Apelqvist, Jan and Stenström, Anders},
  issn         = {0001-6470},
  language     = {eng},
  number       = {4},
  pages        = {387--393},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica Scandinavica},
  title        = {Local signs and symptoms in relation to final amputation level in diabetic patients. A prospective study of 187 patients with foot ulcers},
  url          = {http://dx.doi.org/10.3109/17453679408995476},
  volume       = {65},
  year         = {1994},
}