A Comparison of Adverse Short-Term Outcomes Following Forefoot Amputation Performed on an Inpatient Versus Outpatient Basis

Meyr, Andrew J.; Skolnik, Jennifer; Mateen, Sara; Sansosti, Laura E.

doi:10.1053/j.jfas.2020.07.007

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…There is little information about diabetic foot surgery performed on an outpatient basis. In a retrospective study in which 70% of patients had diabetes, Meyr et al 9 reported no differences in short-term outcomes following forefoot amputations. In that study, 65.5% of the patients had an infection.…”

Section: Discussionmentioning

confidence: 97%

“…A notable difference between the study by Meyr et al 9 and the present research is that those authors closed the wounds after amputation, whereas the present approach was to leave the wound open to heal by secondary intention. Further, those authors 9 reported a higher readmission rate after outpatient procedures than was found in the present study (23.6% vs 12.7%).…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8] The safety of surgical treatment of DFIs on an outpatient basis has not previously been evaluated. Meyr et al 9 reported no differences in short-term adverse outcomes following forefoot amputation with primary closure in patients hospitalized versus outpatients but did not specifically address patients with DFIs.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outpatient Foot-Sparing Surgery Is Safe in Selected Patients with Diabetic Foot Infections

Aragón-Sánchez,

Víquez-Molina,

López-Valverde

et al. 2024

Adv Skin Wound Care

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OBJECTIVE To determine if outpatient foot-sparing surgery for patients with diabetic foot infections (DFIs) is associated with a higher rate of treatment failure or longer healing time. METHODS In this prospective observational study, the authors consecutively recruited a cohort of 200 patients with moderate and severe DFIs from the Diabetic Foot Unit of Hospital San Juan de Dios, Caja Costarricense de Seguro Social, San José de Costa Rica, Costa Rica from October 15, 2020 to December 15, 2021. They compared outpatients with those admitted. Cox univariate analysis was performed, with time to treatment failure and time to healing as dependent variables and outpatient management as the independent variable. RESULTS Seventy-one patients underwent surgery on an outpatient basis (35.5%), and 129 (64.5%) were admitted. Sixty of 111 patients (54.1%) with moderate infections were treated as outpatients versus 11 of 89 (12.4%) of those with severe infections. Twelve (16.9%) of the outpatients and 26 (20.2%) of those admitted presented failure (P = .57). The Cox univariate analysis with time to failure of treatment associated with outpatient management reported a hazard ratio of 1.26 (95% CI, 0.64–2.50; P = .50), and the analysis regarding healing time reported a hazard ratio of 0.91 (95% CI, 0.66–1.25; P = .56). CONCLUSIONS Foot-sparing surgery on an outpatient basis was safe in more than half the cases of moderate DFIs, especially in patients with osteomyelitis. This approach is not associated with treatment failure or a longer healing time. Patients with severe infections, penetrating injuries, necrosis, or high inflammatory response and those with peripheral arterial disease who require revascularizations should be admitted to the hospital.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%