Healing and Mortality Rates Following Toe Amputation in Type 2 Diabetes Mellitus.

BACKGROUND AND AIM: This single-centre study aimed to determine healing, re-ulceration, re-amputation and mortality rates at one year after toe amputations in patients with type 2 diabetes (T2DM). PATIENTS AND METHODS: Eighty-one participants with T2DM admitted for toe amputation were included. Patient characteristics, peripheral circulation and neuropathy status were recorded. Subjects were then followed every 3 months post-amputation for a year. RESULTS: Overall, 59.3% of participants underwent further surgery (n=31 to revise the original amputation site and n=17 to amputate a new site). During 12 months, 45.7% of participants presented with a new ulcer at a different site. Mortality was 7.4%. In 12.4% of participants, the amputation site remained incompletely healed. Only 20.9% had no complications in 12 months. At 12 months, 80.2% of study cohort had a completely healed amputation site. CONCLUSION: In conclusion, this study highlighted high re-intervention, re-amputation and new ulceration rates. Strategies to improves these outcomes in such high-risk patients are warranted.

Comparing Calcium Alginate Dressings to Vacuum-assisted Closure: A Clinical Trial.

INTRODUCTION: Several treatment modalities and protocols for arterial wound ulcers are available; however, little consensus exists on which treatment modality provides the best results. The present study sought to compare and evaluate the clinical efficacy of vacuum-assisted closure wound therapy to calcium alginate dressings in the treatment of neuroischemic diabetic foot ulceration. MATERIAL AND METHODS: A single-center quasi-experimental matched subject clinical trial was conducted on 30 subjects living with type 2 diabetes and presenting with a newly diagnosed neuroischemic foot ulceration. Subjects were divided into 2 groups. Group A (n = 15) underwent negative pressure wound therapy and Group B (n =15) underwent treatment using calcium alginate dressings. Ulcer area and depth were measured during the trial. RESULTS: Both negative pressure therapy and calcium alginate dressings were effective in reducing the surface area and depth of ulcers (P = 0.0001). However, negative pressure was 3.2 times more effective in reducing surface area and 3.78 times more effective in reducing depth of ulcers when compared to calcium alginate (P = 0.0001). CONCLUSION: Vacuum-assisted closure should be considered as the treatment of choice for neuroischemic ulceration owing to its advantages in reducing surface area and depth when compared to calcium alginate dressings. Improved care could result in improved health outcomes, improved quality of life, and fewer diabetes-related foot complications.