Abdul Rashid Surahio, Ashar Ahmad Khan.
Amputations and Diabetes Mellitus: an institutional experience.
J Surg Pak Jan ;13(3):124-7.

Objective: To find out pattern and causes of amputations in patients presenting to surgical units at our hospital. Study design: Descriptive study. Place and Duration of study: Al-Noor Specialist Hospital, Makkah, Saudi Arabia, from March 2004 to June 2006. Patients and Methods: Data was collected from patient`s record for those who were admitted to the hospital for amputation during this period. Results: The analysis of data was done for 50 patients who were amputated during the study period. Males were 36 (72%) and females 14 (28%). Forty two (84%) were Saudi`s and 8 (16%) belonged to other nationalities. Fifty percent were middle aged (45-64 years). Duration of stay was 3 days to 48 days and maximum number (44%) of patients stayed for 3-7 days. Service units were noted that showed 82% in general surgery ward. There were 43(86%) amputations due to diabetes with peripheral neuropathy and circulatory disorder. Forty-two (84%) patients improved and 5(10%) were discharged against medical advice (DAMA) after amputation whereas 3 patients (6%) died. Twenty two (44%) patients had only single admission while one (2%) patient was admitted for nine times. Maximum amputations were at the level of toes (54%) followed by around knee 17(34%). In 19 (38%) patients amputation was done under general anesthesia. Five (10%) patients were amputated more than one time with same problem. Conclusions: Diabetes with peripheral vascular disease and neuropathy were the main causes of amputations in our study and foot amputations were more than half of the total amputations. Special emphasis should be paid to foot care services and patient`s education to prevent amputations and subsequent high disability.

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