title: Local biological factors that influence amputations in diabetic patients.
abstract: Lower extremity amputation is one of the worst complications of diabetes, as it usually has a life expectancy that is below that of most cancers. Four local biologic factors-ulcer, ischemia, neuropathy, and infection-have been shown to be related to amputation. These factors interact with one another, such that neuropathy has been shown to cause ulcers and ischemia and to prevent the healing of ulcers. In addition, ischemia and neuropathy are independent risk factors for infection. More coordinated efforts are needed to create better grading schemes and therapeutic protocols.
authors.affiliation: From the Departments of Pathology and General Surgery, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
authors.forename: Mitchell S
authors.initials: MS
authors.lastname: Wachtel
authors.forename: Eldo E
authors.initials: EE
authors.lastname: Frezza
mesh_terms: D000671:Amputation, Surgical / Q000193:education* / Q000639:trends*; D002983:Clinical Competence; D048909:Diabetes Complications / Q000453:epidemiology / Q000601:surgery*; D004502:Education, Medical, Continuing / Q000592:standards*; D006801:Humans; D007866:Leg / Q000601:surgery*; D012955:Societies, Medical; D014481:United States / Q000453:epidemiology