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https://hdl.handle.net/2440/22886
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dc.contributor.author | Adam, D. | - |
dc.contributor.author | Raptis, S. | - |
dc.contributor.author | Fitridge, R. | - |
dc.date.issued | 2006 | - |
dc.identifier.citation | European Journal of Vascular and Endovascular Surgery, 2006; 31(2):151-156 | - |
dc.identifier.issn | 1078-5884 | - |
dc.identifier.issn | 1532-2165 | - |
dc.identifier.uri | http://hdl.handle.net/2440/22886 | - |
dc.description.abstract | Background: This study examines trends in the presentation and surgical management of acute diabetic foot problems in a single institution. Method: Prospective audit of all diabetic patients who had a primary procedure for critical lower limb ischaemia (CLI) and/or foot sepsis between 1st January 1990 and 31st December 2002. Primary and secondary intervention, mortality and limb salvage rate within 6 weeks of the index procedure were recorded. Results: There were 661 patients (417 men and 244 women of median age 69, range 31–99, years) with 799 affected limbs. CLI alone was present in 625 (78%) limbs, combined CLI and foot sepsis in 53 (7%) and foot sepsis alone in 121 (15%). The primary intervention was minor amputation in 323 (40%) limbs, revascularisation in 288 (36%), major amputation in 185 (23%) and sympathectomy in three limbs. Within 6 weeks, 125 (16%) limbs required secondary intervention, the peri-procedural mortality rate was 38 of 924 (4%), and the limb salvage rates for patients with CLI, combined CLI and sepsis and sepsis alone were 66, 66 and 80%, respectively. There was a significant decline in the proportion of patients presenting with CLI alone and a significant increase in the proportion presenting with combined CLI and sepsis and sepsis alone. In patients with CLI alone, there was a significant increase in the primary major amputation rate and a significant decline in the minor amputation rate with no significant change in the revascularisation rate. Conclusion: There has been a progressive decline in the proportion of patients presenting with CLI alone and a greater proportion of patients presenting with an element of foot sepsis. In patients with CLI alone, the primary major amputation rate has increased at the expense of a decline in minor amputation rate. | - |
dc.description.statementofresponsibility | D.J. Adam, S. Raptis and R.A. Fitridge | - |
dc.language.iso | en | - |
dc.publisher | W B Saunders Co Ltd | - |
dc.rights | Copyright © 2005 Elsevier Ltd All rights reserved. | - |
dc.source.uri | http://dx.doi.org/10.1016/j.ejvs.2005.05.039 | - |
dc.subject | Diabetic foot, Surgery, Workload | - |
dc.title | Trends in the presentation and surgical management of the acute diabetic foot | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1016/j.ejvs.2005.05.039 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Fitridge, R. [0000-0001-6258-5997] | - |
Appears in Collections: | Aurora harvest 6 Surgery publications |
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