Intriguing data from Choi, et al.
With age, presence of osteomyelitis, glucose control all non-contributory it was renal disease, limited activity before surgery, a low hemoglobin level, a high white blood cell count, a high C-reactive protein level, and one vessel runoff or worse were significantly associated with the success or failure of limb salvage.
As noted in the caption and K-M curve, above, five-year survival rate was 81.6% for the limb salvage success group and 36.4% for the limb salvage failure group (P < 0.05).
This constellation of complications in both groups shows that the people studied here are quite sick. However, the excellent survival in the limb salvage group raises the possibility that aggressive intervention in the right patient at the right time may extend quantity (and, let’s hope) quality of life.
The goal of salvage surgery in the diabetic foot is maximal preservation of the limb, but it is also important to resect unviable tissue sufficiently to avoid reamputation. This study aims to provide information on determining the optimal amputation level that allows preservation of as much limb length as possible without the risk of further reamputation by analyzing several predictive factors.