AlRashed Rema, Albogomi Faisal A, Almudaiheem Faisal A, Almutairi Talal A, Albassam Khalid A, Aljaber Fahad K, Alharbi Hussam A
General Surgery, Prince Sultan Military Medical City, Riyadh, SAU.
Vascular Surgery, Prince Sultan Military Medical City, Riyadh, SAU.
Cureus. 2024 Nov 18;16(11):e73947. doi: 10.7759/cureus.73947. eCollection 2024 Nov.
Vascular complications from diabetes contribute significantly to major and minor limb amputations. Diabetes is a major health burden in Saudi Arabia, with increased incidence in rural areas. The purpose of this study was to evaluate the timing of minor lower limb amputations after revascularization and their relative outcomes.
This was a retrospective study done in Prince Sultan Military Medical City, Riyadh, Saudi Arabia. Patients who underwent minor lower limb amputation after revascularization during 2018-2022 were included in the study.
Of the 90 patients who were eligible for the study, 83 (94%) were diabetic, and 66 (73%) underwent revascularization. The timing between revascularization and amputation varied, with 34 (37.8%) amputations occurring on the same day as revascularization, 17 (18.9%) occurring within seven days of revascularization, and 39 (43.3%) occurring more than seven days post-revascularization. No significant differences in amputation (p=0.105) were observed based on the timing of amputation after revascularization. Diabetic patients showed significantly higher rates of wound infection (p=0.028) and longer healing times (p=0.000). Finally, diabetic patients were more likely to have healing times of more than 60 days (25.9%) compared to non-diabetic patients (20.0%).
Based on our results, the timing of endovascular or surgical repair did not affect patient outcomes. Moreover, diabetes was found to be a prognostic factor for poor wound healing and infection.
糖尿病引起的血管并发症是导致大、小截肢的主要原因。糖尿病是沙特阿拉伯的一项重大健康负担，农村地区发病率有所上升。本研究的目的是评估血管重建术后小下肢截肢的时间及其相关结果。
这是一项在沙特阿拉伯利雅得苏丹王子军事医疗城进行的回顾性研究。纳入2018年至2022年期间血管重建术后接受小下肢截肢的患者。
在90名符合研究条件的患者中，83名（94%）患有糖尿病，66名（73%）接受了血管重建。血管重建与截肢之间的时间各不相同，34例（37.8%）截肢与血管重建在同一天进行，17例（18.9%）在血管重建后7天内进行，39例（43.3%）在血管重建后7天以上进行。根据血管重建后截肢的时间，截肢情况无显著差异（p=0.105）。糖尿病患者的伤口感染率显著更高（p=0.028），愈合时间更长（p=0.000）。最后，糖尿病患者愈合时间超过60天的可能性（25.9%）高于非糖尿病患者（20.0%）。
根据我们的结果，血管内或手术修复的时间并不影响患者的预后。此外，糖尿病被发现是伤口愈合不良和感染的一个预后因素。
