J Korean Foot Ankle Soc.  2019 Mar;23(1):18-23. 10.14193/jkfas.2019.23.1.18.

Statistical Analysis of the Risk Factors for Single Toe Amputation Patients in Wound Healing

Affiliations
  • 1Department of Orthopedic Surgery, Inje University College of Medicine, Seoul, Korea. orthoman@paik.ac.kr

Abstract

PURPOSE
This study compared and analyzed the risk factors that affect a wound healing group and healing failure group.
MATERIALS AND METHODS
From 2010 to 2018, 39 patients who had suffered a single toe amputation were evaluated retrospectively. The patients were divided into two groups (wound healing group and healing failure group - within at least 3 months following the amputation). Regarding the possible risk factors, age, gender, Wagner and Brodsky classifications, duration of diabetes mellitus, whether the patient had peripheral arterial occlusive disease (PAOD) or cardiovascular disease, body mass index, HbA1c, total cholesterol, estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), smoking, and alcohol were investigated.
RESULTS
The mean duration of diabetes mellitus was 140 months in the healing group and 227 months in the healing failure group, and the duration of diabetes was significantly longer in the failure group (p=0.009). A significant difference in eGFR was observed between the two groups (59.17 mL/min/1.73 m2 in the healing group and 31.1 mL/min/1.73 m2 in the failure group) (p=0.022). Sixteen patients with PAOD were found, all 10 patients in the healing failure group were PAOD patients.
CONCLUSION
To reduce the additional complications in single toe amputation patients, the underlying disease and appropriate treatment are the most important factors. In addition, a more proximal level of amputation also should be considered in cases of patients with PAOD, high BUN and low eGFR, and patients with long-term diabetes.

Keyword

Toe amputation; Diabetes mellitus; Arterial occlusive disease
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