Lower-limb Amputations in Patients With Diabetes Mellitus

Abstract

It is estimated that approximately 23.6 million people in the United States have diabetes mellitus. With adequate control of this disease and appropriate foot care and basic surveillance, many patients can lead active and healthy lifestyles. However, some patients experience complications associated with poorly controlled glucose levels, including lower-extremity ulcerations and infections. When conservative measures have failed in treating these conditions, a lower-extremity amputation is an option for patients seeking to gain maximal functional recovery. A complete preoperative workup includes assessment of healing potential and preoperative ambulatory status, control or optimization of comorbidities when possible, and determination of amputation level using modern diagnostic modalities. Once the decision to proceed with an amputation has been made, it is important to choose an appropriate level of amputation and practice sound surgical technique. This article describes the preoperative evaluation and operative techniques involved in performing amputations on diabetic patients and reviews the current literature on the most common lower-extremity amputations performed in the care of infections in the feet of patients with diabetes mellitus.

Unnatural Deaths in a National Cohort of People Diagnosed With Diabetes

“…and circulatory complications (8), as well as with lower-limb amputation (9) and comorbid mental illness (10). It is, therefore, unsurprising that premature death occurs more frequently in this population (11)(12)(13)(14)(15)(16).…”

Antioxidant and Antimicrobial Potentials of Seed Oil from Carthamus tinctorius L. in the Management of Skin Injuries

“…Diabetic, pressure, and vascular ulcers are the major forms of chronic wounds [ 11 , 12 ]. Due to peripheral vascular disease, reduced blood flow and thus reduced tissue nutrition and oxygenation can lead to increased vulnerability of the skin to pathogens from the surrounding microbiota [ 9 , 12 ]. Poorly treated decubitus ulcers in bedridden or elderly patients can even cause sepsis, especially in nosocomial infections.…”

The Effect of Clinical Pathway Implementation on Healing of Post Lower Limb Amputation for Diabetic Patients

“…Early planning and teaching regarding stump care is standard precautions that have been considered for preparing the patient for continuity of care before discharge (12) . It has been consistently shown that the best results of diabetic stump care occur when clinical pathway /an interdisciplinary approach is taken toward treatment (13) .…”