Amputation prevention in an independently reviewed at-risk diabetic population using a comprehensive wound care protocol.
An independent review panel composed of an orthopedic surgeon, a vascular surgeon, and an endocrinologist was convened to conduct a case history review. The 71 patients reviewed had 124 wounds on 81 limbs and participated in the comprehensive wound management program of the University of Minnesota. Based on their expertise, the review panel classified the wounds by severity and identified the limb's risk for amputation. The resulting scores were then compared with the patient's actual outcome. The review panel predicted 65 (80%) of the limbs would be salvaged and 16 (20%) would be amputated. The actual outcome was that 75 (93%) of the limbs were salvaged and 6 (7%) were amputated (p less than 0.005). The university's wound management program was highly successful, compared with the predictions of the reviewers.
Knighton
D R
DR
Wound Healing Clinic, University of Minnesota, Minneapolis.
Fylling
C P
CP
Fiegel
V D
VD
Cerra
F
F
D000671:Amputation, Surgical; D000704:Analysis of Variance; D002985:Clinical Protocols; D048909:Diabetes Complications; D006801:Humans; D012189:Retrospective Studies; D012883:Skin Ulcer / Q000150:complications / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D012907:Smoking / Q000009:adverse effects