1137 Perioperative Glycaemic Control in Patients Undergoing Major Lower Limb Amputation – How Can We Improve?

Abstract

Abstract Aim Patients with diabetes undergoing major lower limb amputation (MLLA) have higher rates of unfavourable postoperative outcomes compared to those without diabetes. Inadequate glycaemic management can lead to an increase in wound healing problems, infections, increased length of hospital stay and higher mortality rates. Guidelines from the Vascular Society for Great Britain and Ireland recommend that all MLLA patients should have early input from the Diabetes team. Our study aimed to evaluate local practice in perioperative glycaemic control in MLLA patients at our unit. Method All patients who underwent MLLA between November 2021 and April 2022 were identified by reviewing theatre records. Patient records were reviewed to collect data on diagnosis of diabetes, diabetic medications, capillary blood glucose (CBG) levels on admission, preoperative HbA1c levels, and perioperative and post-operative glycaemic control. Results 33 MLLA were performed (17 AKA, 16 BKA), age range 41 to 85 (mean age 66), 20 male and 13 female patients. 25 patients (76%) were diabetic, 19 patients (58%) had a preoperative HbA1c recorded and all 33 patients had a CBG recorded on admission. 10 diabetic patients (40%) were found to have inappropriate management of their diabetic medication. 18 patients (55%) were identified as having poor glycaemic control on admission (HbA1c >48 or CBG >11.1). Of these, 12 (67%) were reviewed by the Diabetes team. Conclusions Surgical teams must be actively involved in the management of diabetes of their MLLA patients. Patients undergoing MLLA should have HbA1c checked on admission to help identify those who need review by the Diabetes team.