Re-amputation occurrence in the diabetic population in South Wales, UK

Abstract

The incidence of re-amputation following lower extremity amputations (LEA) among the diabetic patients referred to the Artificial Limb and Appliance Centers (ALAC) in South Wales, UK, was investigated. Manual and electronic data-gathering systems were used to extract the medical records of 473 people with various causes of LEA referred to the ALAC in South Wales during 2001-2003. The data included demographic information, causes of amputation and occurrence of various levels of re-amputation. Two hundred and five subjects with diabetes underwent 316 amputations, 44 were foot amputations and 272 major amputations on the ipsilateral and contra-lateral sides. Of the diabetic patients, 45.9% with single LEA underwent re-amputations with 22% incidence of contra-lateral LEA within 2 years. In comparison, 15% underwent re-amputations in the non diabetic dysvascular patients. Ipsilateral re-amputations occurred much earlier (average 21 weeks) compared with the contra-lateral amputations which took an average of 82 weeks following the first amputation. Nearly half of the diabetic patients with single LEA referred for rehabilitation underwent re-amputations within 2 years; out of which 22% of the patients underwent contra-lateral LEA. Although the progression of level of amputations does not follow a particular pattern, re-amputation on the contra-lateral side occurred almost four times later than that on the ipsilateral side.