Ethical decision-making in the amputation versus limb salvage context requires consideration of respect for patient autonomy, beneficence, and nonmaleficence. The surgical options demonstrate near equivalent outcomes for traumatic indications, while reconstruction is generally favored for threatened limbs due to diabetic complications. The decision for amputation versus limb salvage must be considered in each individual patient's situation, with a shared decision-making process of paramount importance. Discussion should involve the best, worst, and most likely case for each surgical option to allow the patient to better understand the range of potential postoperative courses and make an informed decision.
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http://dx.doi.org/10.1016/j.ocl.2024.01.006 | DOI Listing |
J Vasc Surg Cases Innov Tech
April 2025
Hospital Universitário Professor Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil.
Objective: The integrity of the plantar flap is important for transmetatarsal amputation (TMA) classic closure. However, in ischemic wounds, the plantar flap can be compromised, making the TMA coverage difficult. The aim of this study was to compare the outcomes of rotational vs long plantar flaps for transmetatarsal amputation closure in patients with dysvascular partial foot amputations.
View Article and Find Full Text PDFJ Diabetes Complications
January 2025
Kansas College of Osteopathic Medicine, Kansas Health Science University, Wichita, KS, USA. Electronic address:
Peripheral artery disease leading to chronic limb threatening ischemia (CLTI) represents a significant concern for up to 11.0 % of patients with diabetes, often culminating in amputation of the affected limb. This retrospective cohort study explores frequency of comorbid behavioral health conditions (CBHCs) in patients with diabetes and hospital stay characteristics related to post-lower extremity amputation (LEA).
View Article and Find Full Text PDFArthrosc Sports Med Rehabil
December 2024
Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, U.S.A.
Purpose: To evaluate the maximal load to failure, cyclic displacement, stiffness, and modes of failure of onlay subpectoral biceps tenodesis with an intramedullary unicortical metal button (MB) versus an inlay, all-suture Caspari-Weber (CW) technique.
Methods: Sixteen matched paired human cadaveric proximal humeri were randomly allocated for subpectoral BT with either CW or MB using a high-strength suture (N = 16; 8 male, 8 female, mean age = 82.5 years, range 62-99 years).
Antibiotics (Basel)
December 2024
Division of Infectious Diseases, Department Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.
The optimal antimicrobial treatment duration for diabetes-related foot osteomyelitis (DFO) currently needs to be determined. We systematically reviewed the effects of short and long treatment durations on outcomes of DFO. We performed a systematic review searching Cochrane, CENTRAL, MEDLINE, Embase, and CINAHL Plus from inception up to 19 January 2024.
View Article and Find Full Text PDFInt J Vasc Med
December 2024
Department of Medical-Surgical Therapy, Medicine and Health Sciences Faculty, University of Extremadura, Badajoz, Spain.
Diabetes mellitus (DM) is one of the most common chronic endocrine diseases, characterized by hyperglycemia, due to abnormal nitric oxide synthesis. The trend of an increase in the number of patients with DM continues. The medical and economic burden of DM is not only associated with hyperglycemia management but also with the management of DM-related complications.
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