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

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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; Apelqvist, Jan; Stenström, Anders.

In: Acta Orthopaedica Scandinavica, Vol. 65, No. 4, 1994, p. 387-393.

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T1 - Local signs and symptoms in relation to final amputation level in diabetic patients. A prospective study of 187 patients with foot ulcers

AU - Larsson, Jan

AU - Agardh, Carl-David

AU - Apelqvist, Jan

AU - Stenström, Anders

N1 - The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Department of Orthopaedics (Lund) (013028000), Unit on Vascular Diabetic Complications (013241510), Diabetes and Endocrinology (013241530)

PY - 1994

Y1 - 1994

N2 - 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.

AB - 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.

U2 - 10.3109/17453679408995476

DO - 10.3109/17453679408995476

M3 - Article

VL - 65

SP - 387

EP - 393

JO - Acta Orthopaedica

JF - Acta Orthopaedica

SN - 1745-3682

IS - 4

ER -