Author/Authors :
BaumfelD, Daniel Hospital das Clínicas - Belo Horizonte, MG, Brazil , BaumfelD, Tiago Hospital das Clínicas - Belo Horizonte, MG, Brazil , maceDo, Benjamim Hospital Felício Rocho - Belo Horizonte, MG, Brazil , ZamBelli, RoBeRTo Hospital Mater Dei - Belo Horizonte, MG, Brazil , lopes, feRnanDo Hospital Mater Dei - Belo Horizonte, MG, Brazil , neRy, caio Universidade Federal de São Paulo – UNIFESP, São Paulo, SP, Brazil
Abstract :
Objective: There are no specific criteria that define the level of
amputation in diabetic patients. The objective of this study was
to assess the influence of clinical and laboratory parameters in
determining the level of amputation and the wound healing time.
Methods: One hundred and thirty-nine diabetic patients were
retrospectively assessed. They underwent surgical procedures due
to infection and/or ischemic necrosis. Type of surgery, antibiotic
use, laboratory parameters and length of hospital stay were eval-
uated in this study. Results: The most common amputation level
was transmetatarsal, occurring in 26 patients (28.9%). The wound
healing time increased with statistical significance in individuals
undergoing debridement, who did not receive preoperative anti-
biotics and did not undergo vascular intervention. Higher levels
of amputation were statistically related to limb ischemia, previous
amputation and non-use of preoperative antibiotics. Conclusion:
Patients with minor amputations undergo stump revision surgery
more often, but the act of always targeting the most distal stump
possible decreases energy expenditure while walking, allowing
patients to achieve better quality of life. Risk factors for major
amputations were ischemia and previous amputations. A protective
factor was preoperative antibiotic therapy. Level of Evidence III,
Retrospective Study
Keywords :
Diabetic foot , Amputation , Antibiotics , Wound healing , Risk factors , Protective factors
