Is There a Higher Risk of Wound Complications and Reoperation after Below-knee Amputation When Diabetes and Peripheral Artery Disease Coexist? A Retrospective Study

Abstract Background: Below-knee amputation (BKA) is used to treat foot ulcers caused by diabetes mellitus (DM) or peripheral arterial disease (PAD). Wound healing potential is limited because of impaired vascular perfusion and insufficient soft-tissue coverage. However, few studies have compared postoperative wound complications after BKA in patients with DM, PAD, or both. Objectives: This study aimed to evaluate the reoperation rates in the three groups. We hypothesized that the risk of wound complications after BKA is higher if DM and PAD coexist. Materials and Methods: We retrospectively collected data on demographics, indications for amputation, diagnoses of DM or PAD, comorbidities, laboratory data, and occurrence of reoperation. The primary outcome was unplanned reoperation within 1 year. The Chi-square test was used to compare categorical variables. One-way analysis of variance was used to compare differences in continuous variables. Continuous variables between reoperation and nonreoperation groups were compared using t -tests. Results: This study included 281 patients with either DM ( n = 136), PAD ( n = 26), or both ( n = 119). The overall reoperation rate was 17.8%. The reoperation rates among groups were not significantly different. No significant predictors of postoperative wound complications were identified. The relationship between the reoperation rate and comorbidities was not identified. Conclusions: The coexistence of DM and PAD did not significantly cause wound complications or reoperation after BKA compared to those with either DM or PAD alone.