title: A multidisciplinary approach and surgical tips in major amputations of diabetic patients.
abstract: We aim to describe the results obtained in major amputations (transtibial and transfemoral) of diabetic patients followed with a close combined approach (medical and surgical). We evaluated 37 cases with an average age of 73.55 years. All were admitted in our Diabetology Department where they were monitored and treated in order to reach a new balance concerning cardiac failure, anemia, and other pathologies. Then, the orthopedic surgeons operate choosing an adequate level for amputation and pointing about adequate stump covering, accurate vessel, perineural and periosteal hemostasis, and nerve thermoablation. Reading literature we discovered in our series an improvement concerning perioperative mortality, considering the high average age and the bad general conditions of our patients; at the same time, we obtained an improvement about neuromas and ghost limb syndrome versus literature. About walking capabilities we had similar results compared to previous papers, obtaining the worst results for thigh amputations.
authors: 1st Orthopaedic Department, University of Pisa, Pisa, Italy. rosati1961@gmail.com
authors: Marco
authors: M
authors: Rosati
authors: Michele
authors: M
authors: Lisanti
authors: Alessandro
authors: A
authors: Baluganti
authors: Lorenzo
authors: L
authors: Andreani
authors: Loredana
authors: L
authors: Rizzo
authors: Alberto
authors: A
authors: Piaggesi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000379:methods* / Q000534:rehabilitation; D003299:Cooperative Behavior; D003925:Diabetic Angiopathies / Q000601:surgery*; D004704:Endocrinology / Q000458:organization & administration*; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007866:Leg / Q000098:blood supply / Q000601:surgery*; D008297:Male; D008511:Medicine; D008875:Middle Aged; D051346:Mobility Limitation; D009985:Orthopedics / Q000458:organization & administration*; D010348:Patient Care Team; D016491:Peripheral Vascular Diseases / Q000601:surgery; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D011300:Preoperative Care; D012086:Reoperation; D012189:Retrospective Studies; D014945:Wound Healing