The international journal of lower extremity wounds最新文献

{"title":"Impact of Podiatric Surveillance on Amputation Rates in Patients with Diabetes and Chronic Kidney Disease.","authors":"Stephanie Behme, Christopher Girgis, Brian M Schmidt","doi":"10.1177/15347346251337862","DOIUrl":"https://doi.org/10.1177/15347346251337862","url":null,"abstract":"<p><p>Development of the triad of peripheral arterial disease, peripheral neuropathy, and end stage renal disease puts people with diabetes at an increased risk of diabetic foot ulcerations and subsequent infections that often precede lower extremity amputations. In patients on hemodialysis, there is a ten-fold increased risk of amputation and an estimated 40%-82% one-year mortality rate if the amputation is a major amputation. This study aimed to examine if patients presenting to a podiatric clinic with stage 3a or 3b chronic kidney disease and a diabetic foot ulcer had decreased rates of amputations as compared to patients who presented after initiating dialysis. Our results demonstrated all major amputations occurred in patients who did not establish with podiatry prior to initiating HD. Additionally, our study revealed a potential access to care disparity for African American patients with chronic kidney disease, as African American patients were established with podiatry prior to initiating dialysis less often in comparison to Caucasian individuals. Our study lays the groundwork for future work investigating the impact of podiatric surveillance on patients with diabetes and end stage renal disease.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251337862"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot Implementation of a Thermography-Driven Preventive Foot Care Protocol for Diabetes-Related Foot Ulcers in Community Health Centers: Non-Randomized Controlled Trial.","authors":"Makoto Oe, Haryanto Haryanto, Kanae Mukai, Mao Kunimitsu, Suriadi Jais","doi":"10.1177/15347346251337267","DOIUrl":"https://doi.org/10.1177/15347346251337267","url":null,"abstract":"<p><p>AimThe purpose of this study was to clarify the effectiveness and implementation issues of a thermography-driven preventive foot care protocol for diabetes-related foot ulcers in Indonesian community health centers.MethodsIn the two trial centers examined between May 2023 and May 2024, one provided protocol-based care (Intervention group; n = 71), while the other provided standard education (Control group; n = 71). Participants were monitored for ulceration over a 1-year period.ResultsThere was no significant difference in the number of participants with ulceration between the intervention and control group (6 vs 8 cases, p = 0.573). However, there was a shorter time to ulceration (203.8 ± 8.7 vs 350.0 ± 13.9 days, p = 0.048) in the intervention group. Over the 1-year follow-up, protocol compliance was 100% for examinations, but 0% for callus and nail care. Participants without risk factors, such as neuropathy or angiopathy, also developed ulcers.ConclusionsResults suggested this protocol was ineffective in the community health center. It will be necessary to clarify the risk factors for foot ulcers in the target population, establish an appropriate protocol, prepare an environment for its implementation, and then conduct a randomized controlled trial in the future.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251337267"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathology is More Reliable Than Microbiology for Detecting Residual Osteomyelitis After Conservative Surgery for Diabetic Foot: The Pitfall of False-Positive Cultures and the Role of Pseudomonas aeruginosa.","authors":"Gerardo Víquez-Molina, José María Rojas-Bonilla, Javier Aragón-Sánchez","doi":"10.1177/15347346251338689","DOIUrl":"https://doi.org/10.1177/15347346251338689","url":null,"abstract":"<p><p>The optimal method for assessing residual osteomyelitis after conservative surgery for diabetic foot infection remains controversial. Microbiological cultures are frequently used due to their rapid turnaround and utility in guiding antibiotic therapy, but their diagnostic reliability is uncertain. This study compared microbiological cultures and histopathology in evaluating bone resection margins, using histopathology as the gold standard. We included 93 patients undergoing conservative surgery for diabetic foot osteomyelitis. Bone samples were obtained from the proximal resection margin for both microbiology and histopathology. A microbiological result was considered contamination when cultures were positive but histopathology was negative. Microbiological cultures at bone resection margins yielded 52 true positives, 23 false positives (contamination), 10 false negatives, and 8 true negatives when compared to histopathology. This resulted in a sensitivity of 83.9%, specificity of 25.8%, positive predictive value of 69.3%, and negative predictive value of 44.4%. Contamination was not associated with the severity of infection, presence of soft tissue involvement, inflammatory markers, or glycemic control. No association was found between contamination and polymicrobial flora in the primary surgical specimen. However, <i>Pseudomonas aeruginosa</i> was the only species significantly associated with contamination (p = .008), suggesting species-specific factors may contribute to microbiological false positives. These findings emphasize that microbiology, while sensitive, is not a specific method for assessing residual bone infection and should not be used in isolation. Histopathology remains the more reliable diagnostic tool. Future research should explore biofilm-targeted strategies and intraoperative antiseptic protocols to reduce contamination of bone biopsy specimens obtained from resection margins.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251338689"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Heel Ulcers on Patients Admitted for Diabetic Foot Disease.","authors":"Martina Salvi, Marco Meloni, Federico Rolando Bonanni, Ermanno Bellizzi, Valeria Ruotolo, Aikaterini Andreadi, Alfonso Bellia, Davide Lauro","doi":"10.1177/15347346251337264","DOIUrl":"https://doi.org/10.1177/15347346251337264","url":null,"abstract":"<p><p>The current study aimed to evaluate the clinical outcomes of patients admitted for diabetic foot ulcers (DFUs) located in the heel. The study is a retrospective observational study including a population of patients admitted for DFUs from April 2024 to September 2024. According to the wound location, patients were divided in two groups: those with heel ulcers and those with forefoot/midfoot ulcers without calcaneal involvement. All patients have been managed through a limb salvage protocol in the respect of international guidelines. The following hospital outcomes were evaluated: minor and major amputation, mortality, length of stay, need for regenerative surgery by using dermal-epidermal graft. Overall, 150 patients were included. The mean age was 70.2 ± 12.2 years, most patients were male (76.0%), had type 2 diabetes (92.7%) with a mean duration of 22.1±13.2 years; 27 (18%) patients had heel ulcers, while 123 (82%) had forefoot/midfoot lesions. Outcomes for patients with heel location and without were: minor amputation (18.5 vs 32.5%, p = 0.1), major amputation (7.4 vs 0.8%, p = 0.02), mortality (0 vs 0.8%, p = 0.5), length of hospital stay (17.5 ± 8.5 vs 14.4 ± 8.7 days, p = 0.08), need for regenerative therapy using dermal-epidermal substitutes (48.1 vs 19.5%, p = 0.003) respectively. In addition, heel ulcer was found to be an independent predictor for major amputation [OR 5.06, CI95% (3.1-11.4), p = 0.02] and length of stay [OR 6 CI95% (3.6-10.9), p = 0.003]. In patients admitted for DFUs, wounds located in the heel were associated to an increased risk of major amputation, need for regenerative therapy and length of stay (even though in the limit of statistical difference) than wounds not located in the heel. These data underline the need for tailored management strategies in this high-risk subgroup of patients.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251337264"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gremlin-1 and Wagner Classification: Potential Biomarker for Amputation in Diabetic Foot Patients.","authors":"Şeyma Açık, Şevki Çetinkalp, Çiğdem Gözde Aslan, Yasemin Akçay","doi":"10.1177/15347346251337157","DOIUrl":"https://doi.org/10.1177/15347346251337157","url":null,"abstract":"<p><p>Diabetic foot (DF) is a significant complication with high morbidity and mortality, often resulting from neuropathy and ischemia. In our study, we aimed to evaluate the relationship between serum Gremlin-1 levels and disease severity based on the Wagner classification in DF patients, and to determine its prognostic value in predicting the need for amputation.Eighty-five patients with DF ulcers or considered at high risk for DF were included in the study. The patients' complications were evaluated, and laboratory results were obtained from their records. The Wagner classification was applied, and serum Gremlin-1 levels were analyzed using the ELISA method.It was found that as the Wagner stage of the DF increased, Gremlin-1 levels decreased significantly at the statistical borderline (p = 0.05). In the group of patients who underwent amputation, Gremlin-1 levels decreased significantly (p < 0.05). The sensitivity of Gremlin-1 in predicting amputation, with a cut-off value of 2.47 ng/ml, was 67%, and its specificity was 46%. Additionally, a positive correlation was found between total cholesterol, LDL, fasting glucose, and Gremlin-1 (p < 0.05). In the group of patients with an HbA1c value >7.5%, Gremlin-1 levels increased significantly (p < 0.05). In patients with albuminuria, serum Gremlin-1 levels decreased significantly (p < 0.05).It was determined that Gremlin-1 plays a role through an unknown mechanism in DF patients, and its levels decrease as the Wagner stage increases. Gremlin-1 levels were significantly decreased in the amputation group (p < 0.05). It was shown that Gremlin-1 could be a prognostic marker for predicting amputation.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251337157"},"PeriodicalIF":0.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuromuscular Electrostimulation of the Common Peroneal Nerve Increases Microvascular Flux in the Wound bed of Diabetic Foot Ulcers.","authors":"David C Bosanquet, Melissa Blow, Faye Ashton, Keith Harding","doi":"10.1177/15347346251331254","DOIUrl":"https://doi.org/10.1177/15347346251331254","url":null,"abstract":"<p><p>ObjectiveTo measure the effect of neuromuscular stimulation of the common peroneal nerve on the microvascular blood flow within the wound bed of diabetic foot ulcers.Research Design and Methods13 patients with diabetic foot ulcers (11 neuropathic, 2 neuroischemic) were recruited. Microvascular flux and pulsatility were measured in real time in the wound bed, and at the wound edge, using Laser Speckle Contrast Imaging (Moor FLPI-2; Moor Instruments Ltd, Axminster, United Kingdom). Changes from baseline were measured when the leg muscle pump was activated by 1 Hz neuromuscular stimulation of the common peroneal nerve, using a wearable device (geko, Firstkind Ltd Daresbury, United Kingdom).ResultsIn the 11 neuropathic ulcers, significant increases were seen in all microvascular parameters. Wound bed flux increased by 36% (95%CI 11%-68%, <i>P</i> = .002), and peri-wound flux increased by 92% (95%CI 46%-160%, <i>P</i> = .001). Pulsatility in the wound bed increased by 183% (95%CI 61%-517%, <i>P</i> = .005), while pulsatility in the peri-wound increases by 359% (95%CI 264%-455%, <i>P</i> = .001). Additionally, an increase in flux and pulsatility was observed in the neuroischemic ulcers.ConclusionsNeuromuscular stimulation of the common peroneal nerve presents a mode of activating the leg muscle pump without additional pressure insult to the foot and has potential to support the microcirculation during wound-healing, effectively emulating exercise without any of the attendant risks of exercise to the neuropathic or neuroischemic foot.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251331254"},"PeriodicalIF":0.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Effects of Weekly and Biweekly Low-Frequency Ultrasound Debridement Versus Standard of Wound Care in Patients with Diabetic Foot Ulcers: A Pilot Randomized Clinical Trial.","authors":"Sebastián Flores-Escobar, Yolanda García-Álvarez, Francisco Javier Álvaro-Afonso, Mateo López-Moral, Marta García-Madrid, José Luis Lázaro-Martínez","doi":"10.1177/15347346251332795","DOIUrl":"https://doi.org/10.1177/15347346251332795","url":null,"abstract":"<p><p>The aim of this study was to evaluate clinical effects of weekly (UD/week) and biweekly (UD/2-weeks) low-frequency ultrasound debridement (UD) on wound healing, healing time, wound area, granulation tissue, and transcutaneous oxygen pressure (TcPO₂) in patients with diabetic foot ulcers (DFUs), compared to the standard of care (SoC). A pilot randomized clinical trial was conducted involving 30 patients with DFUs who received either UD/week (n = 10), UD/2-weeks (n = 11), or SoC (n = 9) every week over a 12-week treatment period. Healing rates at 6 months were 70% in the UD/week, 54.4% in the UD/2-weeks, and 33.3% in the SoC (<i>P</i> = .27). The healing times were 11 (IQR 7-19) weeks for UD/week, 18 (IQR 15-36) weeks for the SoC, and 24.5 (IQR 16-30) weeks for the UD/2-weeks group (<i>P</i> = .036). Wound area was reduced by 87.5 ± 18.5% in the UD/week, 68.6 ± 26.2% in the UD/2-weeks, and 38.9 ± 16.6% in the SoC (<i>P</i> = .014). Wollina wound scores were 7 (IQR 6-7) in the UD/week, 7 (IQR 6.5-7) in the UD/2-weeks, and 4 (IQR 3-6) in the SoC (<i>P</i> = .002). UD/week showed not significantly higher healing rates than the UD/2-weeks and SoC, but experienced significantly shorter healing time, a greater percentage of wound area reduction and higher Wollina wound score. These findings suggest that UD/week could be a valuable therapeutic option in clinical practice, particularly for patients in whom sharp debridement is not a viable option or who require an alternative approach to promote wound healing. This study is registered in ClinicalTrial.gov.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251332795"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Serum Uric Acid Levels are Associated with Severe Diabetic Foot Infection: A Cross-Sectional Study from China.","authors":"Jie Zhao, Xiaowei Wei, Ping Zhu, Mei Zhang, Zhangrong Xu, Aihong Wang","doi":"10.1177/15347346251319080","DOIUrl":"https://doi.org/10.1177/15347346251319080","url":null,"abstract":"<p><p><b>Diabetic</b> foot ulcers (DFUs) are among the most serious complications of diabetes which are associated with high disability and mortality rates. This study aims to investigate the associations between uric acid (UA) levels and diabetic foot ulcer (DFU) characteristics. In total, 1820 participants with DFUs were included in this study; 192 and 1628 participants were included in the hyperuricemia group (HUA, UA > 420 µmol/L) and the nonhyperuricemia group (NHUA, UA ≤420 µmol/L), respectively. The NHUA group was divided into a middle-UA subgroup (SMUA, 420 µmol/L ≥ UA ≥ 180 µmol/L; 304 individuals) and a low-UA subgroup (SLUA, UA <180 µmol/L; 1324 individuals). There were no significant differences in the rates of deep ulcers, severe infection or amputation between NHUA and HUA. In univariate analysis of subgroups, the differences in the rates of deep ulcers, severe infection and amputation were significant. After adjusting for confounders (sex, fasting glucose level, diabetes duration, eGFR, deep ulcers and severe infection) in multivariate analysis, the severe infection rate (OR = 4.0, 95%CI 1.6-10.0, P < 0.01) was still significantly greater in the SLUA group than in the SMUA group while the rate of deep ulcers (OR =2.4, 95%CI 1.0-6.1, P = 0.06) and amputation (OR =1.1, 95%CI 0.3-4.3, P = 0.91) showed non-statistical difference. UA levels below 180 µmol/L can be a risk factor for severe infection in DFUs.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251319080"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence of Contact Allergies for Wound Dressings in Patients With Diabetic Foot Ulcers (PAID Study), an Observational Prospective Trial.","authors":"Birgitte M Visch, Daphne van der Veen, Luuk Smeets, Roland Toeter, Arianne van Bon, Diana Romijn","doi":"10.1177/15347346251332028","DOIUrl":"https://doi.org/10.1177/15347346251332028","url":null,"abstract":"<p><p>This investigator initiated prospective observational study investigates the prevalence of contact allergies in patients with a Diabetic Foot Ulcer (DFU). Patients with a DFU received a combined PATCH-test (a test used to investigate the origin of an allergic reaction on the skin) at the upper back, with the European baseline series, the European leg ulcer series, and local used material for leg ulcers. A total of 108 patients with DFU were included of which 86 (79.6%) were male, and 9 (8.3%) and 99 (91.7%) patients had Type 1 and Type 2 diabetes, respectively. Twenty-one patients had a sensitization in the standard series, 30 patients in the leg ulcer series, and 11 patients in both series. Two patients had a positive reaction for one of the local used materials. Most frequent sensitizations were found for Perubalsem (N = 6) and Fragrance-Mix II (N = 4) in the standard series. A sensitization for Povidone-Iodine (N = 20) was most frequently seen in the leg ulcer series. In the local used materials a sensitization for silver sulfadiazine (N = 1) and cutimed-gel (n = 1) were seen. In conclusion, this study provides novel information about sensitizations in patients with DFU, but more research is needed to demonstrate the relationship between allergic reactions and delayed wound healing. The study protocol was registered in www.clinicaltrials.gov (NCT04085705, PAID study).</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251332028"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Relationship Between SVS WIfI and IWGDF Scoring Systems and Reamputation Risk in Patients With Diabetic Foot and Peripheral Artery Disease.","authors":"Alkan Bayrak, Mustafa Yalın, Mehmet Utku Çiftçi, Malik Çelik, Vedat Öztürk, Serdar Hakan Basaran","doi":"10.1177/15347346251333835","DOIUrl":"https://doi.org/10.1177/15347346251333835","url":null,"abstract":"<p><p>Determining the optimal amputation level in diabetic foot (DF) and peripheral artery disease (PAD) patients is crucial for minimizing reamputation risk while preserving functionality. The Society for Vascular Surgery Wound, Ischemia, and Foot Infection (SVS WIfI) and International Working Group on Diabetic Foot (IWGDF) scoring systems are widely used for risk stratification, but their predictive value for reamputation remains unclear. The current study aimed to evaluate the predictive utility of these scoring systems for reamputation risk in patients undergoing amputations due to DF or PAD. A retrospective cohort study was conducted on 108 patients who underwent unilateral amputations due to DF or PAD between 2016 and 2021. Patients were categorized based on WIfI and IWGDF classifications, and clinical outcomes, including reamputation rates, ICU admissions, and mortality, were analyzed using logistic regression and post hoc analyses. Reamputation occurred in 41 (38%) patients. Higher WIfI (OR: 3.85, 95% CI: 2.10-7.05, <i>P</i> = .001) and severe IWGDF scores (OR: 3.25, 95% CI: 1.80-5.88, <i>P</i> = .008) significantly correlated with increased reamputation risk. Patients with high-risk scores also exhibited higher ICU admission (<i>P</i> = .03) and mortality rates (<i>P</i> = .01). Male gender (OR: 3.47, 95% CI: 1.45-8.31, <i>P</i> = .005), diabetes (OR: 2.32, 95% CI: 1.10-4.90, <i>P</i> = .027), and prolonged hospitalization (OR: 1.04, 95% CI: 1.01-1.08, <i>P</i> = .021) were independent predictors, while above-ankle amputations were protective for reamputation (OR: 0.22, 95% CI: 0.11-0.43, <i>P</i> < .001). Both scoring systems are effective in predicting reamputation risk, with WIfI providing a more comprehensive risk assessment. Combining these tools may enhance decision-making and improve patient outcomes in terms of reamputation prevention, hospital stay, ICU admission, and mortality.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251333835"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}