Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
5902264 | Journal of Diabetes and its Complications | 2015 | 4 Pages |
AimTo identify any significant differences in physiological test results between healing and non healing amputation sites.MethodsA single center prospective non-experimental study design was conducted on fifty subjects living with type 2 diabetes and requiring a forefoot or toe amputation. Subjects underwent non-invasive physiological testing preoperatively. These included assessment of pedal pulses, preoperative arterial spectral waveforms at the ankle, absolute toe pressures, toe-brachial pressure index and ankle-brachial pressure index. After 6 weeks, patients were examined to assess whether the amputation site was completely healed, was healing, had developed complications, or did not heal.ResultsThere was no significant difference in ABPI between the healed/healing and the non-healing groups. Mean TBI (p = 0.031) and toe pressure readings (p = 0.014) were significantly higher in the healed/healing group compared to the non healing group. A significant difference was also found in ankle spectral waveforms between the two groups (p = 0.028).ConclusionsTBIs, toe pressures and spectral waveforms at the ankle are better predictors of likelihood of healing and non-healing after minor amputation than ABPIs. ABPI alone is a poor indicator of the likelihood of healing of minor amputations and should not be relied on to determine need for revascularization procedures before minor amputation.