Rates and Risk Factors of Diabetic Foot Reamputations

The aim of this study is to determine the reamputation rate in patients who had amputation surgery in our hospital with the diagnosis of diabetic foot and to analyze the comorbid factors. Of 131 patients with detailed information in their files 66 patients who had amputation surgery are included in the study. Age, gender, smoking habits, comorbid diseases, number, level, side and time period of amputation surgeries experienced, presence of infection, wound culture growth of microbes, presence of leukocytosis and method of treatment are recorded. Diabetic foot ulcers of the patients are graded with Wagner-Meggit classification depending on the depth of the wound. Wounds are also evaluated in three different pathophysiological groups as neuropathic, neuropathic-ischemic and ischemic. Levels of amputation were digital, ray, transmetatarsal, below-knee transtibial and aboveknee transfemoral. Ipsilateral or contralateral reamputations in previosly amputated patients were investigated. Of the 66 patients who experienced amputation or reamputation surgery 45 were males and 21 were females. Mean age was 63,2 ( 26-88 ). 11 patients had reamputation surgery. 7 patients had ipsilateral reamputations at a more proximal level, 2 patients had contralateral side amputations and ipsilateral more proximal level reampuations and 2 patients had contralateral side amputations. Wagner-Meggit classification of the wounds in amputated patients yielded 4 Grade3, 40 Grade4, 11 Grade5 wounds where as 7 Grade4, 4 Grade5 wounds in reampuatated patients. Pathophysiological classification yielded 6 neuropathic, 21 neuroischemic and 28 ischemic wounds in amputation group where as 4 neuroischemic and 7 ischemic wounds in reamputation group. Evaluation of diabetes dependent and nondependent comorbid risk factors as well as the physiological capacity of the patients are important as much as selecting accurate level of amputation level with the aid of new diagnostic techniques in decreasing reamputation risk and rates.