Amputations of the lower extremities add significantly to the morbidity and mortality of patients with diabetes and chronic kidney disease (CKD). Dialysis nurses are in an optimal position to make a positive impact on the high rate of amputation among patients with diabetes receiving dialysis through early detection and intervention. Routine foot screening and education can assist in identifyin...

OBJECTIVE Amputations of the lower extremity due to irreversible ischemic tissue loss are performed as distally as possible. Therefore, oftentimes wound-healing disorders develop, requiring additional surgical treatment. METHODS The amputations stumps of 10 patients with irreversible ischemic tissue loss due to arteriosclerosis were investigated within 72 hours postoperatively with indocyanin...

BACKGROUND Diabetic foot infections are a frequent clinical problem. About 50% of patients with diabetic foot infections who have foot amputations die within five years. Properly managed most can be cured, but many patients needlessly undergo amputations because of improper diagnostic and therapeutic approaches. DISCUSSION The article debates the pros and cons of amputation of the diabetic fo...

Rigid plaster dressings and immediate postoperative prostheses (IPOP) in patients undergoing transtibial amputations have been reported to reduce pain and healing time, prevent knee flexion contractures, and expedite early ambulation compared to soft dressings. Yet, despite the reported benefits, surgical adoption of (conventional) rigid dressings and IPOP has been inconsistent. The purpose of ...

The frequency of nontraumatic lower limb amputations in persons with diabetes has increased in the United States over the last decade. Currently two-thirds of all lower limb amputations occur in individuals with diagnosed diabetes. High geographic variation in age, sex, and race-adjusted amputation rates across U.S. populations suggest that important differences in practice patterns exist and t...

UNLABELLED We sought to describe the bone bridge technique in adults, and present a variation for use in children, as well as to present its applicability as an option in elective transtibial amputations. This paper presents a prospective study of 15 transtibial amputations performed between 1992 and 1995 in which the bone bridge technique was employed. The patients' ages ranged from 8 to 48 ye...

BACKGROUND To our knowledge, there have been no previously published reports characterizing lower-extremity amputations in Canada. The objective of this study was to describe the indications and outcomes of lower-extremity amputations in the Canadian population. METHODS We performed a retrospective cohort study of all adult patients who underwent lower-extremity amputation in Canada between 2...

OBJECTIVE To compare survival rates after first amputation between patients with and without diabetes. RESEARCH DESIGN AAND METHODS: We performed a retrospective study of all nontraumatic amputations performed at our center in the years 1990-1995 in patients with (n = 100) and without (n = 151) diabetes. Survival status was assessed from the first amputation until 31 December 2001. RESULTS Al...

We set out to evaluate a clinical foot-screening programme in terms of primary outcomes (reductions in the incidence of ulcers and lower limb amputation) and process outcomes (compliance with screening, the number of patients not completing the programme and the use of chiropody services and prescribed footwear and cost). All but 4 of 2001 patients attending a general diabetic out-patient clini...

OBJECTIVE To provide a mechanism-based acute pain management strategy for early phantom limb pain following traumatic amputations and to collect first evidence of its acute and potentially preventative effects on the formation and maintenance of phantom limb pain. The combination of continuous brachial plexus analgesia and prolonged block of N-methyl-D-aspartate (NMDA) receptors over 4 weeks ai...