A comparative study on lower extremity amputation (LEA) stump outcome in diabetic and non-diabetic patients in a tertiary care hospital of Raipur City, Chhattisgarh, India.

ABSTRACT

Background: Amputation is among the oldest operation known to man. It is the surgical removal of a limb or body part and performed to remove diseased tissue or relieve pain. Amputation is associated with some complications. Infection and failure of stump to heal are major complications. The Diabetes related Lower Extremity Amputation (LEA) is likely to be associated with a worse outcome as compared to the non-diabetic amputations because of the presence of several risk factors which hamper the wound healing process. Amputees with diabetes are more likely to undergo amputation at a younger age and need higher-level amputations when compared with patients without diabetes. With this background, the present study was planned to understand the factors that place diabetic patients at increased risk of amputation in the study area so that further morbidity can be prevented. Methods: The current prospective study was conducted in the Department of Surgery, Dr. B.R.A.M. Hospital, Pt. JNM Medical College, Raipur (C.G.) India, among 60 patients admitted in the General Surgery wards during January 2013 to August 2014. Study subjects were categorized into those related to diabetes mellitus and those due to other causes. All Investigations relevant to the study (Random blood sugar, Serum albumin, Complete blood count, renal function test and Doppler) were done in all the patients. Postoperatively the cases were examined for various complications of amputation stump in post operative period were noted. Results: Mean age for diabetic cases was 50 years and that for non-diabetic cases was 47 years. In this study, among the diabetic amputations, 84 % were males and 16 % were females. Total 60 amputations were performed in the study. Stump infection (50 % in diabetics and 29 % in non-diabetics) was the most common stump complication. Followed by wound dehiscence (25 % in diabetics and 11 % in non-diabetics) Conclusion: Diabetic amputations are at a higher risk of complications. They need to be carefully screened and selected for appropriate level of amputation and watched meticulously for occurrence of complications.