FACTORS AFFECTING THE RESULTS OF BELOW KNEE AMPUTATION IN PATIENTS WITH AND WITHOUT DIABETES

  • 1 January 1982
    • journal article
    • research article
    • Vol. 155  (4) , 513-518
Abstract
During a 5 yr period, 113 below knee amputations were performed upon 100 patients. Multiple factors were examined for their effects on wound complication and reamputation rates. Healing without reamputation occurred in 91.9% of those in the diabetic group and in 76.5% of those in the nondiabetic group, P < 0.05. Cellulitis of the foot did not significantly affect healing below the knee in patients with diabetes, 82.5% with cellulitis vs. 87.5% without cellulitis, P > 0.05, but did affect healing in those in the nondiabetic group, 81.8% success vs. 66.7%, P < 0.05, and affected their minor wound complication rate, 50.0% with cellulitis vs. 26.5% without cellulitis. Absence of femoral pulses uniformly predicted a nonhealing occurred in 85%. Hb levels were inversely proportional to success rates only in patients with diabetes and cellulitis, 10.54 .+-. 1.68 vs. 12.85 .+-. 2.30 g/d for failures, P = 0.016. Elevated white blood counts were predictive of failure to heal below the knee amputations only in those in the nondiabetic group without cellulitis, 10,110 .+-. 3200 cells/m3 for success vs. 13,750 .+-. 3300 cells/m3 for failures, P = 0.018. Use of wound drains correlated with a 55.0% wound complication rate vs. 16.1% when drains were not used. Wound complications were minimized when amputations were closed with subcuticular suture and skin tapes.

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