Comparison between primary minor amputations and minor amputations with previous revascularization in diabetic foot pathology

Introduction: the performance of primary minor amputations in diabetic patients is a frequent practice in vascular surgery services. The aim of this study is to compare the evolution of minor primary amputations, with those performed with previous revascularization, considering the presence or not of a direct angiosome that revascularizes the stump area that we are going to create. Material and methods: on observational and comparative study was performed on diabetic patients who required minor lower limb amputations admitted to our department during the period from January to December 2018.The revascularization prior, or not, to minor amputation, was decided based on hemodynamic studies and possibilities according to imaging tests. Patients were divided into 4 groups considering the need-possibility of revascularization prior to minor amputation, and vascularization based on direct or indirect a ngiosome to the area of the stump that we were going to create. The rate of major amputations, the healing rate of minor amputations, and mortality were assessed in each group. We consider significant p < 0.05. Results: 106 patients were recruited, from January to December 2018. The healing rate of the amputation stumps in the four groups did not show statistically significant differences (p - 0.085). Non-revascularized patients showed a higher rate of limb loss respect the previously revascularized group, with a statistically significant difference between the groups (p= 0.002). Conclusions: the rate of limb loss is higher in patients who do not undergo revascularization surgery prior to minor amputation, as well as in patients whose vascularization depends on indirect angiosomes to the created stump.