Transmetatarsal amputation versus multiple toes amputations for non-ischemic diabetic foot infection management.

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland Pub Date : 2025-09-05 DOI:10.1016/j.surge.2025.08.005

Moustafa Mabrouk, Ahmed Fouda, Mohammed ElKassaby

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引用次数: 0

Abstract

Background: The management of diabetic foot infections (DFIs) is a complex multidisciplinary process and often necessitates surgical interventions. Unfortunately, amputations such as single or multiple toes amputations (MTA) or full transmetatarsal amputation (TMA) are often the unavoidable solution. This study aimed to compare the clinical outcomes of TMA versus MTA in managing non-ischemic diabetic foot infections.

Methods: This was a retrospective study on non-ischemic diabetic foot infection patients comparing the results of TMA and MTA in terms of healing, ulcer recurrence and overall complications, including further formal amputations.

Results: The healing rate was substantially higher in TMA group (89.3 % vs. 74.5 %, p=0.004). TMA group exhibited a significantly lower incidence of further proximal amputation (8.7 % vs. 21.3 %, p=0.002) and ulcer recurrence (11.3 % vs. 25.3 %, p=0.002). Tissue necrosis occurred less frequently in TMA group (4.5 % vs. 12.8 %, p<0.05). No significant differences were found between the groups regarding infection, hematoma, or residual edema.

Conclusions: Transmetatarsal amputation for diabetic foot infection demonstrated superior healing rates, lower ulcer recurrence, and reduced need for proximal amputation compared to multiple toe amputations for managing non-ischemic diabetic foot infections.

Level of evidence: level 3 retrospective study.

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经跖骨截肢与多趾截肢对非缺血性糖尿病足感染的治疗。

背景：糖尿病足感染（dfi）的治疗是一个复杂的多学科过程，经常需要手术干预。不幸的是，截肢，如单趾或多趾截肢（MTA）或全跖骨截肢（TMA）往往是不可避免的解决方案。本研究旨在比较TMA与MTA治疗非缺血性糖尿病足部感染的临床结果。方法：对非缺血性糖尿病足感染患者进行回顾性研究，比较TMA和MTA在愈合、溃疡复发和包括进一步正式截肢在内的总体并发症方面的结果。结果：TMA组愈合率明显高于TMA组（89.3% vs. 74.5%, p=0.004）。TMA组进一步近端截肢发生率（8.7%比21.3%,p=0.002）和溃疡复发率（11.3%比25.3%,p=0.002）显著降低。TMA组的组织坏死发生率较低（4.5% vs. 12.8%）。结论：与多趾截肢相比，经跖骨截肢治疗糖尿病足感染的治愈率更高，溃疡复发率更低，并且治疗非缺血性糖尿病足感染的近端截肢需求减少。证据等级：3级回顾性研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 医学-外科

CiteScore

4.40

自引率

0.00%

发文量

158

审稿时长

6-12 weeks

期刊介绍： Since its establishment in 2003, The Surgeon has established itself as one of the leading multidisciplinary surgical titles, both in print and online. The Surgeon is published for the worldwide surgical and dental communities. The goal of the Journal is to achieve wider national and international recognition, through a commitment to excellence in original research. In addition, both Colleges see the Journal as an important educational service, and consequently there is a particular focus on post-graduate development. Much of our educational role will continue to be achieved through publishing expanded review articles by leaders in their field. Articles in related areas to surgery and dentistry, such as healthcare management and education, are also welcomed. We aim to educate, entertain, give insight into new surgical techniques and technology, and provide a forum for debate and discussion.