Abstract | BACKGROUND: AIM OF THE STUDY: To assess the outcome of open and closed (minor) amputations in diabetic patients from three hospitals. Patient charts including pathohistology reports were evaluated. PATIENTS: A total of 80 diabetic patients were considered, of whom 47 had critical foot ischaemia ( CFI) Fontaine stage IV, 5 had endstage renal failure with haemodialysis treatment, and 72 had polyneuropathy. RESULTS: During 96 procedures, 60 toes and 48 metatarsal bones were amputated. A closed amputation (CA, n=54), or an open amputation (OA, n=42) had been performed, at the discretion of the surgeons. Toes rather than metatarsal bones were amputated more often with CA than with OA (p=0.0018). Following CA, 14 wounds (26%) healed by primary intention, whereas 40 wound did not; in 15 cases (28%), reamputations were required. Following OA, 26 wounds (62%) healed by secondary intention, and 14 cases (33%) required reamputation. Histopathology revealed osteomyelitis at the osteotomy site in 34 cases (64%) of CA, versus 31 cases (78%) of OA. Following CA, 77% of 9 cases without CFI, and with healthy bone at the osteotomy site healed by primary intention, versus 4% of 25 cases with CFI and osteomyelitis at the osteotomy site (p<0.0001). CONCLUSION:
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Authors | S Ozdemir |
Journal | VASA. Zeitschrift fur Gefasskrankheiten
(Vasa)
Vol. 38 Suppl 74
Pg. 54-61
(Feb 2009)
ISSN: 0301-1526 [Print] Switzerland |
Vernacular Title | Untersuchung zur Effektivität von offenen und geschlossenen Minoramputationen bei diabetischer Gangrän. |
PMID | 19259931
(Publication Type: English Abstract, Journal Article)
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Topics |
- Aged
- Amputation, Surgical
(methods)
- Diabetic Foot
(diagnosis, surgery)
- Female
- Foot
(blood supply, pathology)
- Gangrene
- Humans
- Ischemia
(diagnosis, surgery)
- Limb Salvage
(methods)
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Osteomyelitis
(diagnosis, surgery)
- Postoperative Complications
(diagnosis, surgery)
- Reoperation
(methods)
- Toes
(blood supply, surgery)
- Wound Healing
(physiology)
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