Reamp with id10v23/4/2023 This study aimed to determine the rate of conversion from dry to wet gangrene within 30 days post-procedure in patients who underwent endovascular or open revascularization for critical limb ischemia. There is a paucity of data regarding the conversion rate from dry gangrene to wet gangrene after lower extremity revascularization. Repeated lesions were affected by general conditions, and the contralateral side must be carefully examined after diabetic forefoot amputation. Contralateral lesions occurred 8 months later than ipsilateral lesions, but reamputation above the Lisfranc joint was more frequent and prognosis was poorer. However, the anatomical positions of diabetic foot lesions, causes of lesions, anatomical amputation levels, number of surgeries, and management duration had no significant differences. Repeated lesions were statistically significant in diabetic polyneuropathy, vascular calcification, and dialysis. Of the patients with repeated lesions, 142 and 104 on the ipsilateral and contralateral sides, respectively were also compared and examined. The related factors of repeated lesions were compared and analyzed. Of the 508 selected patients with a follow-up period of at least 6 months, 288 had repeated lesions in the forefoot, and 220 did not have repeated lesions. The medical records of 998 patients who underwent forefoot amputation because of their diabetic feet from March 2002 to February 2021 were retrospectively analyzed. This study was performed to analyze the clinical characteristics, related factors, and prognosis of repeated lesions after diabetic forefoot amputation. The multiple specialties caring for patients with diabetic foot infections need a stronger common knowledge base-from studies like this and future studies-to better counsel patients about their treatment and prognosis. We found no evidence of confounding by comorbidities or infection severity.įor patients with toe infections, foot surgery with bone resection was associated with better healing than debridement alone. This association was modified by infection location and greater for toe infections (4.52 ) than other foot infections (1.19 ). The cumulative incidence of healing after foot surgery with bone resection was greater than that following debridement (risk ratio 1.80, 95% confidence interval ). We used log-binomial regression to assess the association between foot surgery type and healing, stratify by infection location, and evaluate potential confounding variables. The exposure was foot surgery with bone resection (i.e., toe amputation, metatarsal resection, transmetatarsal amputation) versus debridement alone. This was a single-center, retrospective cohort study of 90 Veterans with moderate-to-severe diabetic foot infections between 20 from the VA Maryland Health Care System. The outcomes following these limb-sparing surgeries are not well-described. The treatment of diabetic foot infections involves both medical and surgical management, of which limb-sparing surgeries are increasingly preferred over amputations at or above the ankle to preserve mobility and quality of life. Although the trends that emerge from this project are limited to what is observed in this statistical context, where the number of patients included and the number of total observations per outcome were limited, it highlights interesting data for future research to inform clinical decisions to support best practices for the benefit of patients.ĭiabetic foot infections are a common precursor to lower extremity amputations. Patients with prior amputation showed a higher probability of undergoing another re-amputation with partial ray resection (p = 0.01). There was also a significantly increased likelihood of re-ulceration for people with depression or a history when the partial ray resection was performed (p = 0.02). However, there was a statistically significantly increased likelihood of re-ulceration for patients with CAD who underwent hallux amputation (p = 0.02). Our results suggested no statistical difference between the type of surgery and outcomes such as recurrence of DFU and amputation at 3, 6, and 12 months or death. We also attempted to identify patient characteristics leading to these outcomes. We abstracted data from a cohort of 70 patients followed for a 1-year postoperative period to support clinical practice. Therefore, the purpose of this study was to determine the more definitive surgery between hallux amputation and partial first ray resection. In a similar context, the choice to perform one of these two surgeries is attributable to clinician preference based on experience and characteristics of the patient and the DFU. There are few data comparing outcomes after hallux amputation or partial first ray resection after diabetic foot ulcer (DFU).
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