FACTORS RELATED TO AMPUTATION LEVEL AND WOUND HEALING IN DIABETIC PATIENTS
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Acta Ortopédica Brasileira (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-78522018000500342 |
Resumo: | ABSTRACT Objective: There are no specific criteria that define the level of amputation in diabetic patients. The objective of this study was to assess the influence of clinical and laboratory parameters in determining the level of amputation and the wound healing time. Methods: One hundred and thirty-nine diabetic patients were retrospectively assessed. They underwent surgical procedures due to infection and/or ischemic necrosis. Type of surgery, antibiotic use, laboratory parameters and length of hospital stay were evaluated in this study. Results: The most common amputation level was transmetatarsal, occurring in 26 patients (28.9%). The wound healing time increased with statistical significance in individuals undergoing debridement, who did not receive preoperative antibiotics and did not undergo vascular intervention. Higher levels of amputation were statistically related to limb ischemia, previous amputation and non-use of preoperative antibiotics. Conclusion: Patients with minor amputations undergo stump revision surgery more often, but the act of always targeting the most distal stump possible decreases energy expenditure while walking, allowing patients to achieve better quality of life. Risk factors for major amputations were ischemia and previous amputations. A protective factor was preoperative antibiotic therapy. Level of Evidence III, Retrospective Study. |
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FACTORS RELATED TO AMPUTATION LEVEL AND WOUND HEALING IN DIABETIC PATIENTSDiabetic footAmputationAntibioticsWound healingRisk factorsProtective factorsABSTRACT Objective: There are no specific criteria that define the level of amputation in diabetic patients. The objective of this study was to assess the influence of clinical and laboratory parameters in determining the level of amputation and the wound healing time. Methods: One hundred and thirty-nine diabetic patients were retrospectively assessed. They underwent surgical procedures due to infection and/or ischemic necrosis. Type of surgery, antibiotic use, laboratory parameters and length of hospital stay were evaluated in this study. Results: The most common amputation level was transmetatarsal, occurring in 26 patients (28.9%). The wound healing time increased with statistical significance in individuals undergoing debridement, who did not receive preoperative antibiotics and did not undergo vascular intervention. Higher levels of amputation were statistically related to limb ischemia, previous amputation and non-use of preoperative antibiotics. Conclusion: Patients with minor amputations undergo stump revision surgery more often, but the act of always targeting the most distal stump possible decreases energy expenditure while walking, allowing patients to achieve better quality of life. Risk factors for major amputations were ischemia and previous amputations. A protective factor was preoperative antibiotic therapy. Level of Evidence III, Retrospective Study.ATHA EDITORA2018-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-78522018000500342Acta Ortopédica Brasileira v.26 n.5 2018reponame:Acta Ortopédica Brasileira (Online)instname:Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)instacron:SBOT10.1590/1413-785220182605173445info:eu-repo/semantics/openAccessBaumfeld,DanielBaumfeld,TiagoMacedo,BenjamimZambelli,RobertoLopes,FernandoNery,Caioeng2018-10-30T00:00:00Zoai:scielo:S1413-78522018000500342Revistahttp://www.actaortopedica.com.br/https://old.scielo.br/oai/scielo-oai.php1atha@uol.com.br||actaortopedicabrasileira@uol.com.br1809-44061413-7852opendoar:2018-10-30T00:00Acta Ortopédica Brasileira (Online) - Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)false |
dc.title.none.fl_str_mv |
FACTORS RELATED TO AMPUTATION LEVEL AND WOUND HEALING IN DIABETIC PATIENTS |
title |
FACTORS RELATED TO AMPUTATION LEVEL AND WOUND HEALING IN DIABETIC PATIENTS |
spellingShingle |
FACTORS RELATED TO AMPUTATION LEVEL AND WOUND HEALING IN DIABETIC PATIENTS Baumfeld,Daniel Diabetic foot Amputation Antibiotics Wound healing Risk factors Protective factors |
title_short |
FACTORS RELATED TO AMPUTATION LEVEL AND WOUND HEALING IN DIABETIC PATIENTS |
title_full |
FACTORS RELATED TO AMPUTATION LEVEL AND WOUND HEALING IN DIABETIC PATIENTS |
title_fullStr |
FACTORS RELATED TO AMPUTATION LEVEL AND WOUND HEALING IN DIABETIC PATIENTS |
title_full_unstemmed |
FACTORS RELATED TO AMPUTATION LEVEL AND WOUND HEALING IN DIABETIC PATIENTS |
title_sort |
FACTORS RELATED TO AMPUTATION LEVEL AND WOUND HEALING IN DIABETIC PATIENTS |
author |
Baumfeld,Daniel |
author_facet |
Baumfeld,Daniel Baumfeld,Tiago Macedo,Benjamim Zambelli,Roberto Lopes,Fernando Nery,Caio |
author_role |
author |
author2 |
Baumfeld,Tiago Macedo,Benjamim Zambelli,Roberto Lopes,Fernando Nery,Caio |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Baumfeld,Daniel Baumfeld,Tiago Macedo,Benjamim Zambelli,Roberto Lopes,Fernando Nery,Caio |
dc.subject.por.fl_str_mv |
Diabetic foot Amputation Antibiotics Wound healing Risk factors Protective factors |
topic |
Diabetic foot Amputation Antibiotics Wound healing Risk factors Protective factors |
description |
ABSTRACT Objective: There are no specific criteria that define the level of amputation in diabetic patients. The objective of this study was to assess the influence of clinical and laboratory parameters in determining the level of amputation and the wound healing time. Methods: One hundred and thirty-nine diabetic patients were retrospectively assessed. They underwent surgical procedures due to infection and/or ischemic necrosis. Type of surgery, antibiotic use, laboratory parameters and length of hospital stay were evaluated in this study. Results: The most common amputation level was transmetatarsal, occurring in 26 patients (28.9%). The wound healing time increased with statistical significance in individuals undergoing debridement, who did not receive preoperative antibiotics and did not undergo vascular intervention. Higher levels of amputation were statistically related to limb ischemia, previous amputation and non-use of preoperative antibiotics. Conclusion: Patients with minor amputations undergo stump revision surgery more often, but the act of always targeting the most distal stump possible decreases energy expenditure while walking, allowing patients to achieve better quality of life. Risk factors for major amputations were ischemia and previous amputations. A protective factor was preoperative antibiotic therapy. Level of Evidence III, Retrospective Study. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-78522018000500342 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-78522018000500342 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1413-785220182605173445 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
ATHA EDITORA |
publisher.none.fl_str_mv |
ATHA EDITORA |
dc.source.none.fl_str_mv |
Acta Ortopédica Brasileira v.26 n.5 2018 reponame:Acta Ortopédica Brasileira (Online) instname:Sociedade Brasileira de Ortopedia e Traumatologia (SBOT) instacron:SBOT |
instname_str |
Sociedade Brasileira de Ortopedia e Traumatologia (SBOT) |
instacron_str |
SBOT |
institution |
SBOT |
reponame_str |
Acta Ortopédica Brasileira (Online) |
collection |
Acta Ortopédica Brasileira (Online) |
repository.name.fl_str_mv |
Acta Ortopédica Brasileira (Online) - Sociedade Brasileira de Ortopedia e Traumatologia (SBOT) |
repository.mail.fl_str_mv |
1atha@uol.com.br||actaortopedicabrasileira@uol.com.br |
_version_ |
1752122276098080768 |