J Korean Foot Ankle Soc.  2016 Jun;20(2):78-83. 10.14193/jkfas.2016.20.2.78.

Risk Factors of Syme Amputation in Patients with a Diabetic Foot

• Gwak H
• Kim J
• Kim Y
• Lee J
• Lee W

• KMID: 2219407
• DOI: http://doi.org/10.14193/jkfas.2016.20.2.78

Abstract

PURPOSE
This study examined the factors affecting the treatment of diabetes mellitus foot patients who had undergone a Syme amputation.
MATERIALS AND METHODS
This study included 17 patients diagnosed with a diabetes mellitus foot and who had undergone a Syme amputation from January 2010 to January 2014. Some of the risk factors (age, body mass index [BMI], disease duration, smoking, ankle brachial index [ABI], HbA1c, serum albumin, total lymphocyte, C-reactive protein [CRP], and serum creatine) that affect the successful Syme amputation were analyzed.
RESULTS
The healing rate of a Syme amputation was significantly higher when the lymphocyte count was above 1,500 mm3 (p=0.029). The factors affecting the surgical outcome according to multivariate analysis were HbA1c and the BMI (p=0.014, p=0.013). Regarding reamputation, there was a significant difference with HbA1c, lymphocyte, and BMI (p=0.01, p=0.03, and p=0.01). No significant differences were observed with age, disease duration of diabetes mellitus, smoking, ABI, serum albumin, CRP, and serum creatine.
CONCLUSION
The HbA1c level, BMI and total lymphocyte count are risk factors that must be considered for successful Syme amputation in patients with diabetic foot disease.

Keyword

Diabetic foot; Risk factors; Syme amputation

MeSH Terms

Amputation*
Ankle Brachial Index
Body Mass Index
C-Reactive Protein
Creatine
Diabetes Mellitus
Diabetic Foot*
Foot
Humans
Lymphocyte Count
Lymphocytes
Multivariate Analysis
Risk Factors*
Serum Albumin
Smoke
Smoking
C-Reactive Protein
Creatine
Serum Albumin
Smoke

Figure

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  Figure 1. (A) A 59-year-old man had type II diabetes, amputated toes and skin necrosis. (B) Syme amputation was performed well and walk freely with prosthesis after healing.

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  Figure 2. (A) A 62-year-old man had diabetic foot ulcer. (B) Below knee amputation was performed due to difficulty of infection control and laboratory abnormality.

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