Risk factors for postsurgical diabetic foot recurrence after minor or major lower-limb's amputation

Abstract

Background: Many previous studies on diabetic foot focus on ulceration and amputation, but few studies took on recurrent ulcer or wound infection with several years' follow-up after amputations and studying risk factors such as peripheral arterial disease (PAD), renal disease, cardiovascular disease, and environmental factors which may play a role and explain for that disease recurrence. Aim: The aim of this study was to assess the risk of recurrence of diabetic foot disease after different level of amputations. Patients and Methods: A prospective study was conducted for 32 patients presented with diabetic foot disease. This study started from September 2011 up to December 2016. Those patients who admitted for (minor or major) amputation with risk factor diseases were studied and followed up for any recurrence. Results: Among 32 patients, 17 cases did minor amputation (53.1%), whereas 15 cases (46.9%) did major amputations. The number of patients who developed recurrence was 11 cases distributed, as 8 cases (25%) developed wound infection and other 3 cases (9.4%) developed ulceration. Seven cases of those who developed wound infection (87.5%) after amputation had PAD. All patients who complained recurrent ulceration (100%) had PAD risk factor with P = 0.0001*. Two cases (25%) of those with wound infection and also one case with ulceration had renal disease with P = 0.039*. Conclusion: PAD, renal disease, and renal failure have significant risk factors for recurrence of wound infection and ulceration after diabetic foot–limb amputation.