The Outcome of Surgical Treatment for the Neuropathic Diabetic Foot Lesions—A Single-Center Study
The prevalence of diabetic foot complications is continuously increasing as diabetes has become one of the most important “epidemics” of our time. The main objective of this study was to describe the appropriate surgical intervention for the complicated neuropathic diabetic foot; the secondary goal...
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MDPI AG
2022-07-01
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| Online Access: | https://www.mdpi.com/2075-1729/12/8/1156 |
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| author | Florin Bobirca Catalin Gabriel Smarandache Anca Bobirca Cristina Alexandru Dan Dumitrescu Anca Pantea Stoian Cristina Bica Lacramioara Aurelia Brinduse Anca Musetescu Daniela-Elena Gheoca-Mutu Sebastian Isac Ioan Ancuta |
| author_facet | Florin Bobirca Catalin Gabriel Smarandache Anca Bobirca Cristina Alexandru Dan Dumitrescu Anca Pantea Stoian Cristina Bica Lacramioara Aurelia Brinduse Anca Musetescu Daniela-Elena Gheoca-Mutu Sebastian Isac Ioan Ancuta |
| author_sort | Florin Bobirca |
| collection | DOAJ |
| description | The prevalence of diabetic foot complications is continuously increasing as diabetes has become one of the most important “epidemics” of our time. The main objective of this study was to describe the appropriate surgical intervention for the complicated neuropathic diabetic foot; the secondary goal was to find the risk factors associated with minor/major amputation and good or adverse surgical outcomes. This is an observational, retrospective study conducted between 1 January 2018 and 31 December 2019, which included 251 patients from the General Surgery Department at the Dr I. Cantacuzino Clinical Hospital in Bucharest with type II diabetes mellitus and neuropathic diabetic foot complications. The surgical conditions identified at admission were the following: osteitis (38.6%), infected foot ulcer (27.5%), gangrene (20.7%), infected Charcot foot (3.6%), non-healing wound (3.6%), necrosis (3.2%), and granulated wound (2.8%). We found that a minor surgical procedure (transmetatarsal amputation of the toe and debridement) was performed in 85.8% of cases, and only 14.2% needed major amputations. Osteitis was mainly associated with minor surgery (<i>p</i> = 0.001), while the gangrene and the infected Charcot foot were predictable for major amputation, with OR = 2.230, 95% CI (1.024–4.857) and OR = 5.316, 95% CI (1.354–20.877), respectively. Admission anemia and diabetic nephropathy were predictive of a major therapeutical approach, with <i>p</i> = 0.011, OR = 2.975, 95% CI (1.244–8.116) and <i>p</i> = 0.001, OR = 3.565, 95% CI (1.623–7.832), respectively. All the major amputations had a good outcome, while only several minor surgeries were interpreted as the adverse outcome (<i>n</i> = 24). Osteitis (45.8%) and admission anemia (79.2%) were more frequently associated with adverse outcomes, with <i>p</i> = 0.447 and <i>p</i> = 0.054, respectively. The complicated neuropathic diabetic foot requires a surgical procedure mainly associated with a good outcome. |
| first_indexed | 2024-03-09T13:05:24Z |
| format | Article |
| id | doaj.art-15f89b3656754dfd8d5e61100637f271 |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-09T13:05:24Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-15f89b3656754dfd8d5e61100637f2712023-11-30T21:49:04ZengMDPI AGLife2075-17292022-07-01128115610.3390/life12081156The Outcome of Surgical Treatment for the Neuropathic Diabetic Foot Lesions—A Single-Center StudyFlorin Bobirca0Catalin Gabriel Smarandache1Anca Bobirca2Cristina Alexandru3Dan Dumitrescu4Anca Pantea Stoian5Cristina Bica6Lacramioara Aurelia Brinduse7Anca Musetescu8Daniela-Elena Gheoca-Mutu9Sebastian Isac10Ioan Ancuta11Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaInternal Medicine and Rheumatology Department, Dr Ion Cantacuzino Clinical Hospital, 011437 Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaRheumatology Department, Craiova University of Medicine, 200349 Craiova, RomaniaCarol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaThe prevalence of diabetic foot complications is continuously increasing as diabetes has become one of the most important “epidemics” of our time. The main objective of this study was to describe the appropriate surgical intervention for the complicated neuropathic diabetic foot; the secondary goal was to find the risk factors associated with minor/major amputation and good or adverse surgical outcomes. This is an observational, retrospective study conducted between 1 January 2018 and 31 December 2019, which included 251 patients from the General Surgery Department at the Dr I. Cantacuzino Clinical Hospital in Bucharest with type II diabetes mellitus and neuropathic diabetic foot complications. The surgical conditions identified at admission were the following: osteitis (38.6%), infected foot ulcer (27.5%), gangrene (20.7%), infected Charcot foot (3.6%), non-healing wound (3.6%), necrosis (3.2%), and granulated wound (2.8%). We found that a minor surgical procedure (transmetatarsal amputation of the toe and debridement) was performed in 85.8% of cases, and only 14.2% needed major amputations. Osteitis was mainly associated with minor surgery (<i>p</i> = 0.001), while the gangrene and the infected Charcot foot were predictable for major amputation, with OR = 2.230, 95% CI (1.024–4.857) and OR = 5.316, 95% CI (1.354–20.877), respectively. Admission anemia and diabetic nephropathy were predictive of a major therapeutical approach, with <i>p</i> = 0.011, OR = 2.975, 95% CI (1.244–8.116) and <i>p</i> = 0.001, OR = 3.565, 95% CI (1.623–7.832), respectively. All the major amputations had a good outcome, while only several minor surgeries were interpreted as the adverse outcome (<i>n</i> = 24). Osteitis (45.8%) and admission anemia (79.2%) were more frequently associated with adverse outcomes, with <i>p</i> = 0.447 and <i>p</i> = 0.054, respectively. The complicated neuropathic diabetic foot requires a surgical procedure mainly associated with a good outcome.https://www.mdpi.com/2075-1729/12/8/1156diabetic foot surgeryamputationdiabetes mellitusgangrene |
| spellingShingle | Florin Bobirca Catalin Gabriel Smarandache Anca Bobirca Cristina Alexandru Dan Dumitrescu Anca Pantea Stoian Cristina Bica Lacramioara Aurelia Brinduse Anca Musetescu Daniela-Elena Gheoca-Mutu Sebastian Isac Ioan Ancuta The Outcome of Surgical Treatment for the Neuropathic Diabetic Foot Lesions—A Single-Center Study Life diabetic foot surgery amputation diabetes mellitus gangrene |
| title | The Outcome of Surgical Treatment for the Neuropathic Diabetic Foot Lesions—A Single-Center Study |
| title_full | The Outcome of Surgical Treatment for the Neuropathic Diabetic Foot Lesions—A Single-Center Study |
| title_fullStr | The Outcome of Surgical Treatment for the Neuropathic Diabetic Foot Lesions—A Single-Center Study |
| title_full_unstemmed | The Outcome of Surgical Treatment for the Neuropathic Diabetic Foot Lesions—A Single-Center Study |
| title_short | The Outcome of Surgical Treatment for the Neuropathic Diabetic Foot Lesions—A Single-Center Study |
| title_sort | outcome of surgical treatment for the neuropathic diabetic foot lesions a single center study |
| topic | diabetic foot surgery amputation diabetes mellitus gangrene |
| url | https://www.mdpi.com/2075-1729/12/8/1156 |
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