A retrospective study was made to ascertain the mortality rate among 100 consecutive patients with diabetes mellitus who had undergone lower limb amputations for infection and/or gangrene in the combined medical-orthopedic service of a county hospital. The medical and orthopedic staffs functioned as equal members, and combined decision-making conferences were held regularly. The over-all mortality rate was 9 per cent, a substantial decrease from the 22 to 25 per cent previously reported in similar studies. The mortality rate among patients with below-knee procedures was 1 per cent versus the 7 to 9 per cent reported by others. Close medical-surgical liaison on a service specializing in the care of these often fragile patients with diffuse multisystem disease results in decreased mortality.
One hundred consecutive patients with Diabetes Mellitus and lower limb complications (infection and/or gangrene) needing elective surgery were screened for gas gangrene. The incidence was found to be 10 per cent (one being due to Clostridium welchii). With orthodox conservative treatment, no mortality was encountered.
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