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Rehabilitation Practice and Science

Translated Title

糖尿病足截肢後傷口癒合之探討

Abstract

The foot of the diabetic is most susceptible to the diabetic complications of neuropathy and angiopathy. In such condition, any trauma may quickly lead to ulceration, infection, gangrene and finally, amputation. It is hard to make a decision to the level of amputation due to hostile, and uncoop erative of patient and family, so, postoperative wound healing are different in many cases.This study is a retrospective study, 97 cases due to diabetic ,ammputation who admitted to Chang Gung Memorial Hospital from January, 1978 to December, 1987, were followed up by questionnares and telephone. The patients comprised of 59 males and 38 females, ranging of age from 35 to 87 years with mean age of 62.5±9.8 years. 55 patients (56.7%) received below-knee amputation, 22 (22.7%) received above-knee amputatuin, 16(16.5%) received toe amputation, 3(3.1%) received Syme amputation, and only one received knee disarticulation. After operation only 13 cases (13.4%) had primary wound healing, 17(17.5%) showed fair healing, 56(56.7%) were poor. Unfortunately, 11(11.4%) died in hospital due to complication. In our study, wound healing was not correlates with age, hemoglobin, hematocrit, or albumin level, but strong correlated with blood sugar control after operation. Most of the wound culture showed mixed flora infedtion, average 2.5± 1.1 isolates were obtained. Enterococcus was the most common etiologic agents. Most of the patients in this study had known diabetes mellitus history, only 7 had regular sugar control, 3 of them knew diabetec mellitus after they got leg ulcer. So, education to diabetic control, prevention and recognization of complication is still very important.

Language

Traditional Chinese

First Page

142

Last Page

149

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