Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Apr 15, 2024; 15(4): 629-637
Published online Apr 15, 2024. doi: 10.4239/wjd.v15.i4.629
Prevalence and risk factors of wound complications after transtibial amputation in patients with diabetic foot
Young Uk Park, Seong Hyuk Eim, Young Wook Seo
Young Uk Park, Seong Hyuk Eim, Young Wook Seo, Department of Orthopedic Surgery, Ajou University School of Medicine, Ajou University Hospital, Suwon 16499, South Korea
Author contributions: Park YU and Seo YW designed the research study, and performed the research; Park YU, Seo YW and Eim SH analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Institutional review board statement: Ethical approval for this study was obtained from the Institutional Review Board of Ajou University School of Medicine.
Informed consent statement: The study is retrospective and does not impact human subjects, thereby not requiring consent forms.
Conflict-of-interest statement: The authors received no financial support for the research, authorship, and/or publication of this article.
Data sharing statement: Statistical code, and dataset available from the corresponding author at syw0103@gmail.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Young Wook Seo, MD, Assistant Professor, Doctor, Surgeon, Department of Orthopedic Surgery, Ajou University School of Medicine, Ajou University Hospital, No. 164 World Cup Road, Yeongtong-gu, Suwon 16499, South Korea. syw0103@gmail.com
Received: October 30, 2023
Peer-review started: October 30, 2023
First decision: December 12, 2023
Revised: December 28, 2023
Accepted: February 18, 2024
Article in press: February 18, 2024
Published online: April 15, 2024
Processing time: 164 Days and 19.5 Hours
Abstract
BACKGROUND

Diabetic foot (DMF) complications are common and are increasing in incidence. Risk factors related to wound complications are yet to be established after trans-tibial amputation under the diagnosis of DMF infection.

AIM

To analyze the prognosis and risk factors related to wound complications after transtibial amputation in patients with diabetes.

METHODS

This retrospective cohort study included seventy-two patients with DMF complications who underwent transtibial amputation between April 2014 and March 2023. The groups were categorized based on the occurrence of wound complications, and we compared demographic data between the complication group and the non-complication group to analyze risk factors. Moreover, a multivariate logistic regression analysis was performed to identify risk factors.

RESULTS

The average follow-up period was 36.2 months. Among the 72 cases, 31 (43.1%) had wound complications. Of these, 12 cases (16.7%) received further treatment, such as debridement, soft tissue stump revision, and re-amputation at the proximal level. In a group that required further management due to wound complications after transtibial amputation, the hemoglobin A1c (HbA1c) level was 9.32, while the other group that did not require any treatment had a 7.54 HbA1c level. The prevalence of a history of kidney transplantation with wound complications after transtibial amputation surgery in DMF patients was significantly greater than in cases without wound complications (P = 0.02). Other factors did not show significant differences.

CONCLUSION

Approximately 43.1% of the patients with transtibial amputation surgery experienced wound complications, and 16.7% required additional surgical treatment. High HbA1c levels and kidney transplant history are risk factors for postoperative wound complications.

Keywords: Diabetic foot; Transtibial amputation; Wound complications; Risk factor

Core Tip: In this study, 43.1% of the patients with transtibial amputation surgery experienced wound complications, and 16.7% necessitated additional wound revision procedures, such as debridement. High hemoglobin A1c (HbA1c) levels (HbA1c > 7.2) and kidney transplant history are risk factors for postoperative wound complications.