Park Young Uk, Eim Seong Hyuk, Seo Young Wook
Department of Orthopedic Surgery, Ajou University School of Medicine, Ajou University Hospital, Suwon 16499, South Korea.
World J Diabetes. 2024 Apr 15;15(4):629-637. doi: 10.4239/wjd.v15.i4.629.
Diabetic foot (DMF) complications are common and are increasing in incidence. Risk factors related to wound complications are yet to be established after trans-tibial amputation under the diagnosis of DMF infection.
To analyze the prognosis and risk factors related to wound complications after transtibial amputation in patients with diabetes.
This retrospective cohort study included seventy-two patients with DMF complications who underwent transtibial amputation between April 2014 and March 2023. The groups were categorized based on the occurrence of wound complications, and we compared demographic data between the complication group and the non-complication group to analyze risk factors. Moreover, a multivariate logistic regression analysis was performed to identify risk factors.
The average follow-up period was 36.2 months. Among the 72 cases, 31 (43.1%) had wound complications. Of these, 12 cases (16.7%) received further treatment, such as debridement, soft tissue stump revision, and re-amputation at the proximal level. In a group that required further management due to wound complications after transtibial amputation, the hemoglobin A1c (HbA1c) level was 9.32, while the other group that did not require any treatment had a 7.54 HbA1c level. The prevalence of a history of kidney transplantation with wound complications after transtibial amputation surgery in DMF patients was significantly greater than in cases without wound complications ( = 0.02). Other factors did not show significant differences.
Approximately 43.1% of the patients with transtibial amputation surgery experienced wound complications, and 16.7% required additional surgical treatment. High HbA1c levels and kidney transplant history are risk factors for postoperative wound complications.
糖尿病足（DMF）并发症很常见，且发病率在不断上升。在DMF感染诊断下进行经胫截肢术后，与伤口并发症相关的危险因素尚未明确。
分析糖尿病患者经胫截肢术后伤口并发症的预后及相关危险因素。
这项回顾性队列研究纳入了2014年4月至2023年3月期间接受经胫截肢术的72例DMF并发症患者。根据伤口并发症的发生情况对患者进行分组，比较并发症组和非并发症组的人口统计学数据以分析危险因素。此外，进行多因素逻辑回归分析以确定危险因素。
平均随访期为36.2个月。72例患者中，31例（43.1%）出现伤口并发症。其中，12例（16.7%）接受了进一步治疗，如清创、软组织残端修复以及近端再次截肢。在经胫截肢术后因伤口并发症需要进一步处理的组中，糖化血红蛋白（HbA1c）水平为9.32，而另一组无需任何治疗的患者HbA1c水平为7.54。DMF患者经胫截肢术后伤口并发症患者的肾移植病史患病率显著高于无伤口并发症的患者（ = 0.02）。其他因素未显示出显著差异。
约43.1%的经胫截肢手术患者出现伤口并发症，16.7%需要额外的手术治疗。高HbA1c水平和肾移植病史是术后伤口并发症的危险因素。
