[Reduced Amputation Rate in Patients with Diabetic Foot Syndrome Since the Introduction of a Minimal-invasive Concept].

Abstract

Amputations are always considered "the last option" for patients with vascular diseases. Currently, in Germany, more than 4.5 million patients suffer from diabetes mellitus. Since we introduced the minimally invasive concept for the treatment of diabetic foot syndrome, we have observed, after careful evaluation, a decreasing trend in the rates of minor and major amputations.Ethics and informed consent were ensured in this retrospective evaluation. Approximately 150 patients with complex diabetic foot syndrome are treated annually. Since July 2021, we have been treating our patients with a minimally invasive concept as one of several multidisciplinary modalities. For evaluation, we included and analyzed our diabetic patients who underwent minor and major amputations within the defined time frames from 2018 to 2023 (including revision amputations). We compared the most recent 30 months (group 2) since the introduction of this concept with the preceding 30 months (group 1).A total of 810 patients with any form of diabetic foot syndrome presented at our clinic between 2018 and 2023, of which 242 patients required primary surgical treatment. Patients in group 1 exhibited a major amputation rate of 4%, a minor amputation rate of 13%, and an overall revision surgery rate of 4%. Patients in group 2 displayed a major amputation rate of 2%, a minor amputation rate of 10%, and an overall revision surgery rate of 2%.After the introduction of the minimally invasive concept as an adjustment to our multidisciplinary approach for treating patients with diabetic foot syndrome, we have observed, through our critical evaluation, a declining trend in both minor and major amputation rates. While further research is necessary to confirm or reject our results, the implementation of minimally invasive surgery into the toolkit of regional hospitals may significantly contribute to an improved health status for patients.