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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.

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



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.


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.


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.


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.


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

[Indexed for MEDLINE]

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