DOI: http://dx.doi.org/10.18203/2349-2902.isj20205867

Critical factors leading to wound complications in amputated patients: low hematocrit levels

Sinan Omeroglu, Ibrahim Demir, Metin O. Beyaz

Abstract


Background: Patients with diabetes-induced lower extremity infection and gangrene suffer from post-amputation wound complications. The aim of this report is to identify critical factors leading to wound complications in amputated patients.

Methods: 50 patients with ipsilateral transmetatarsal (TMA) or finger amputation treated in Istanbul University Medical Faculty between 2001 and 2013 were retrospectively reviewed. Amputations were caused by diabetic foot infection. None of the patients had peripheral artery disease (ABPI>1.1).

Results: In 9 (18%) patients, revision was required despite appropriate antibiotherapy after amputation. 7 (78%) of these patients were women, 8 (89%) were smokers and hematocrit levels were below 25% in all of them. 4 of the 5 patients (80%) with chronic kidney disease were among the patients in need of revision.

Conclusion: The risk of wound complications after amputation is high. These complications increase morbidity and treatment costs. This study showed that low hematocrit value is a risk factor for the development of wound infection after amputation.


Keywords


Hematocrit, Diabetic foot, Amputation, Infected wound

Full Text:

PDF

References


Apelqvist J. Diagnostic and treatment of the diabetic foot. Endocrine. 2012;41:384-97.

Brocco E, Ninkovic S, Marin M. Diabetic foot management: multidisciplinary approach for advanced lesion rescue. J Cardiovasc Surg (Torino). 2018;59(5):670-84.

Lepantalo M, Apelqvist J, Setacci C, Ricco JB, De Donato G, Becker F, et al. Chapter V: diabetic foot. Eur J Vasc Endovasc. 2011;42:60-74.

Anthony T, Roberts J, Modrall JG, Huerta S, Asolati M, Neufeld J, Parker B, Yang W, Sarosi G. Transmetatarsal amputation: assessment of current selection criteria. Am J Surg. 2006;192:8-11.

Blume P, Salonga C, Garbalosa J, Pierre-Paul D, Key J, Gahtan V, Sumpio BE. Predictors for the healing of transmetatarsal amputations: retrospective study of 91 amputations. Vascular. 2007;15:126-33.

Younger AS, Awwad MA, Kalla TP, de Vries G. Risk factors for failure of transmetatarsal amputation in diabetic patients: a cohort study. Foot Ankle Int. 2009;30:1177-82.

Sotto A, Richard JL, Messad N. Distinguishing colonization from infection with Staphylococcus aureus in diabetic foot ulcers with miniaturized oligonucleotide arrays: a French multicenter study. Diabetes Care. 2012;35:617-23.

Apelqvist J, Ragnarson-Tennvall G, Persson U, Larsson J. Diabetic foot ulcers in a multidisciplinary setting. An economic analysis of primary healing and healing with amputation. J Intern Med. 1994;235:463-71.

Dinh MT, Abad CL, Safdar N. Diagnostic accuracy of the physical examination and imaging tests for osteomyelitis underlying diabetic foot ulcers: meta‐analysis. Clin Infect Dis. 2008;47:519-27.

Zavadovskaya VD, Zorkal'tsev MA, Udodov VD. Possibilities of a software-based hybrid single photon emission computed tomography/magnetic resonance imaging in the diagnosis of complicated diabetic foot syndrome. Vestn Rentgenol Radiol. 2015;(6):24-9.