Self-injury resulting in amputation among vascular patients: a retrospective epidemiological study.

In the course of 24 months, 164 nontraumatic vascular amputees were accepted for prosthetic rehabilitation; 120 (73%) were diabetic and 44 (27%) non-diabetic. Subjects were divided into two groups, the first consisting of 114 with spontaneous foot infection or gangrene and the second of 50, of whom 44 were diabetic and six had peripheral arterial disease on its own. Sixty-five per cent of all amputees had fewer than nine years of formal education and 46% were in the low-income bracket, but no significant relationship was found between mechanism of self-injury and level of education and income. All patients in the second group were able to detail ways in which they had injured their feet. The relationship between the mechanism of self-injury and the presence of diabetes mellitus was found to be highly significant. By instructing in better self-care it may be possible to prevent or at least postpone amputation in these patients.