Outcome of Toe Amputation in Diabetic Foot Gangrene Patients at CMH Rawalpindi

Abstract

Objective: To study the outcomes of toe amputation performed in diabetic foot gangrene patients during hospital admission at CMH Rawalpindi.
Study Design: Cross-sectional study.
Place and Duration of Study: The study was conducted at the Department of General Surgery, Combined st Military Hospital (CMH), Rawalpindi, Pakistan from 1^st June 2021 to 31^st May 2022.
Methods: 146 patients who had undergone toe amputation were followed in this prospective cohort study. The clinical data was collected and analyzed after informed written consent from patients. The size of the ulcer and surgery method were recorded. After toe amputation, the recovery, insulin therapy, re-ulceration, and reamputation were also recorded with glycated hemoglobin. The data was assessed by using SPSS version 20. The frequency and percentage were calculated for categorical data. For continuous data, mean and standard deviation were calculated.
Results: A total of 146 patients for toe amputations were enrolled in this study. Patients were diagnosed with a mean duration of diabetes of 15.93±3.79 years. There were 121 (82.9%) male participants and 25(17.1%) female participants with a mean age of 49.9±11.11 years. There were 35 (24.0%) patients in which ulcer size < 1 cm², 44 (30.1%) patients with ulcer size 1-5 cm² and 67 (45.9%) cases were with ulcer > 5 cm² in size. Among the individuals studied, 53 (36.3%) showed X-ray examinations confirmed the presence of foot ulcers. Out of the total amputations performed, 70(48%) were revisited with re-ulceration problems. These patients were counselled for re-amputation out of which contralateral major amputation was highly prevalent. Moreover, as shown in Table 2, ipsilateral ulceration 41 (28.1%), and contralateral ulceration 29 (19.9%) were found in patients who had re-ulceration and re-amputation out of 70 (48%) patients. The mean glycated hemoglobin in these patients was 11.02±2.42. Out of the total amputations performed, 2 (3.77%) patients were due to septicemia, 1 (1.88%) from ketoacidosis, and 3 (5.66%) died from retinopathy comorbid with diabetes.
Conclusion: Our study underscores favorable outcomes, including effective infection control and wound healing, contributing to improved patient care and limb preservation. These findings highlight the importance of timely surgical intervention in managing diabetic foot complications. 

How to cite this: Chaudhry IT, Malik MJ, Mahi MAA, Riaz T, Ahmad RN, Makshoof MT. Outcome of Toe Amputation in Diabetic Foot Gangrene Patients at CMH Rawalpindi. Life and Science. 2023; 4(4): 415-420. doi: http://doi.org/10.37185/LnS.1.1.339