Study of below knee amputation in patients with diabetic foot ulcer in a tertiary care centre in India

Background: This study aims to evaluate the predictive factors affecting the clinical outcome of below knee amputation performed in diabetic foot patients who had developed foot ulcers. Methods: This is a retrospective study of 25 random patients who underwent below-knee amputation for diabetic foot ulcers. These patients were admitted in the Department of Surgery, Shri MP Shah Medical College, Jamnagar, between November 2017 and October 2019. Results: The patient’s age ranged from 30 to 80 years, with a mean age of 62.92 years. 60% were between the ages of 51 and 70. Of the total, 14 were male and 11 were female, suggesting that males due to generally more active lifestyles, may be at higher risk for foot injuries leading to diabetic ulcers. 64% were from a lower socio-economic background. All 25 patients had previous admissions, 12 had a history of previous amputation, while 13 treated conservatively. Most patients presented with infected or non-healing ulcers, cellulitis and/or gangrene. Primary healing occurred in 13 patients, 7 required refashioning for healing, 3 required transfemoral amputation and 2 patients unfortunately passed away. The mean duration of hospital stay was 49.82±28.07 days. Conclusions: Lack of awareness, poor glycaemic control and duration of diabetes where the main factors causing diabetic foot problems. For patients with infected feet, difficulty with mobility and prolonged immobilization were common issues. Timely below-knee amputation helped restore movement and improved the ability to use prosthetic limbs, allowing for greater mobility and independence.