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J Wound Care. 2017 May 2;26(5):218-227. doi: 10.12968/jowc.2017.26.5.218.

Outcomes after foot surgery in people with a diabetic foot ulcer and a 12-month follow-up.

Author information

1
Wound Expert Clinic, Haaglanden Medical Centre, The Hague, The Netherlands.
2
Senior Lecturer, Centre for Medical Education, Cardiff University School of Medicine, College of Biomedical and Life Sciences, Cardiff, Wales, UK.
3
Vascular Surgeon; Wound Expert Clinic, Haaglanden Medical Centre, The Hague, The Netherlands.

Abstract

OBJECTIVE:

The aim of this study was to retrospectively measure the outcomes of foot-sparing surgery at one year follow-up for patients with diabetic foot ulcers (DFUs). We assessed wound healing and the need for further surgery in relation to the variables that influence healing.

METHOD:

Data were retrospectively collected by reviewing the electronic files of patients attending the Wound Expert Clinic (WEC). Outcomes of surgical debridement, toe, ray and transmetatarsal amputations were assessed.

RESULTS:

A total of 129 cases in 121 patients were identified for inclusion. The results demonstrated that complete wound healing was reached in 52% (61/117) of the patients within 12 months. The need for additional surgery or for major amputation was 56% (n=72/129) and 30% (n=39/129) respectively. The need for an additional procedure was particularly high after surgical debridement (75%, 33/44) and transmetatarsal amputation (64%, 7/11). Risk factors for non-healing or for a major amputation were: infection (p=0.01), ischaemia (p=0.01), a history of peripheral arterial occlusive disease (p<0.01) and smoking (p=0.01). Additional findings were that not all patients underwent vascular assessment and in half of the patients there was a delay in undergoing revascularisation.

CONCLUSION:

The results of the study reveal some areas for improvement including timely revascularisation and performance of multiple debridement procedures if needed in order to save a limb.

KEYWORDS:

diabetic foot surgery; minor amputation; surgery risk factors; surgical debridement; wound healing

PMID:
28475445
DOI:
10.12968/jowc.2017.26.5.218
[Indexed for MEDLINE]

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