Analysis of Important Factors in Revision Surgery for Patients Undergoing Diabetic Major Lower Extremity Amputation

Authors : Yüksel Topkaya, Özgür Uslu, Mustafa İncesu

Pages : 366-373

Doi:10.22312/sdusbed.1671099

View : 48 | Download : 127

Publication Date : 2025-12-22

Article Type : Research Paper

Abstract :Aim: Diabetic foot is a disease associated with severe morbidity, mortality, and significant socioeconomic problems. Numerous risk factors influence revision amputations in diabetic feet; however, the literature does not reach a consensus on this matter. This study aims to analyze the significant factors affecting revision surgery in patients who have undergone major lower extremity amputations due to diabetes. Materials and Methods: This retrospective study was conducted at a university hospital in İzmir between April 10, 2023, and October 12, 2023. A total of 276 patients who underwent surgical operation due to diabetic foot between 2010 and 2022 were included in the study. The study evaluated the impact of demographic characteristics and various parameters, including a history of peripheral angiography or peripheral bypass, the surgical specialty performing the operation, hemoglobin, platelet count, hemoglobin A1c, albumin, sedimentation rate, C-reactive protein, sodium and potassium levels, lymphocyte-to-neutrophil ratio, blood transfusion requirements, and the Charlson Comorbidity Index, recorded at admission and discharge, on the need for revision surgery. Results: The patients were divided into two groups: those who underwent revision amputation (96) and those who did not (180). The revision amputation rate among all patients was determined to be 35%. The risk of revision amputation can be predicted by the admission and discharge albumin levels, as well as the admission and discharge potassium levels. In addition to high admission albumin levels and low discharge potassium levels, high admission potassium levels may also contribute to the adverse outcomes of revision surgery. Conclusions: In this study, it was found that albumin levels, which are considered important for wound healing in many sources, were not a determining factor for revision amputation as previously thought. Additionally, the regulation of potassium levels, which can be affected by various metabolic diseases, may have a significant impact on the revision surgery that becomes necessary after amputation.
Keywords : Diyabetik ayak, Majör alt ekstremite ampütasyonu, Klinik parametreler, Laboratuvar parametreleri

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