AIMS/HYPOTHESIS: To assess the results of the strategy used in avoiding major amputations in patients with diabetes mellitus. METHODS: A retrospective study for the years 1981 to 1995 in a central district hospital in Copenhagen with a catchment area population of about 178,000. RESULTS: There were 463 major leg amputations and the incidence decreased from 27.2 to 6.9/100,000 population (75%). The decrease in patients with Type I (insulin-dependent) diabetes mellitus was from 10.0 to 4.1 (59%) and in Type II (non-insulin-dependent) diabetes mellitus from 17.2 to 2.8/100,000 people (84%). Analysis showed that the diabetic population remained constant despite a considerable fall in the number of older people. During the study period infra-popliteal arterial bypass was introduced for the treatment of critical lower limb ischaemia and in diabetic patients the number of bypasses increased from zero to 13/100,000 population. The total number of revascularisation procedures in people with diabetes increased from 2.6 to 19.2/100,000 population. Moreover, a multidisciplinary diabetic foot clinic was established. CONCLUSION/ INTERPRETATION: A 75% reduction in the incidence of major amputations coincided with a sevenfold increase in revascularization procedures and the establishment of a multidisciplinary diabetic foot clinic suggesting these measures are important in the prevention of diabetic leg amputations.
AIMS/HYPOTHESIS: To assess the results of the strategy used in avoiding major amputations in patients with diabetes mellitus. METHODS: A retrospective study for the years 1981 to 1995 in a central district hospital in Copenhagen with a catchment area population of about 178,000. RESULTS: There were 463 major leg amputations and the incidence decreased from 27.2 to 6.9/100,000 population (75%). The decrease in patients with Type I (insulin-dependent) diabetes mellitus was from 10.0 to 4.1 (59%) and in Type II (non-insulin-dependent) diabetes mellitus from 17.2 to 2.8/100,000 people (84%). Analysis showed that the diabetic population remained constant despite a considerable fall in the number of older people. During the study period infra-popliteal arterial bypass was introduced for the treatment of critical lower limb ischaemia and in diabeticpatients the number of bypasses increased from zero to 13/100,000 population. The total number of revascularisation procedures in people with diabetes increased from 2.6 to 19.2/100,000 population. Moreover, a multidisciplinary diabetic foot clinic was established. CONCLUSION/ INTERPRETATION: A 75% reduction in the incidence of major amputations coincided with a sevenfold increase in revascularization procedures and the establishment of a multidisciplinary diabetic foot clinic suggesting these measures are important in the prevention of diabetic leg amputations.
Authors: Franziska Großschädl; Wolfgang Freidl; Willibald J Stronegger; Nathalie T Burkert; Johanna Muckenhuber; Éva Rásky Journal: Wien Med Wochenschr Date: 2014-07-29
Authors: Chandan K Sen; Gayle M Gordillo; Sashwati Roy; Robert Kirsner; Lynn Lambert; Thomas K Hunt; Finn Gottrup; Geoffrey C Gurtner; Michael T Longaker Journal: Wound Repair Regen Date: 2009 Nov-Dec Impact factor: 3.617
Authors: Eszter P Vamos; Alex Bottle; Michael E Edmonds; Jonathan Valabhji; Azeem Majeed; Christopher Millett Journal: Diabetes Care Date: 2010-09-10 Impact factor: 19.112