Limb Loss: Facts and Statistics – Diabetes Mellitus and Vascular Insufficiency, a Real Harbinger of Major Limb Amputations – A Cross-sectional Study among Amputees Reporting to a Tertiary Care Center

Abstract

Abstract Background: Limb loss to amputation is a major problem, especially in developing countries where the majority of the cases are preventable. It is a burden, not just for the patient but also for their caregivers. Today, when amputation is necessary, surgery is undertaken with consideration for the functional aspects of the residual limb. The purpose of this study was to describe the etiology and characteristics of major limb amputees at a tertiary care center in North India. Methods: This prospective observational study was conducted by the Government Medical College Jammu, for 2 years. Eighty-one patients underwent major limb amputations in our hospital during the study. In this study, we studied several variables including age, sex, side of the limb, level of the amputation, and etiology. Results: In this study, dysvascular disease was the major reason of amputation, diabetes mellitus being the most common cause (39.5%), followed by trauma, with a male preponderance, with peaking at the age of 51–70 years. Lower limb is the most common with the predominance of transtibial amputation. Younger individuals who underwent amputation were mostly due to the trauma. The most common postoperative complication was surgical site infection (21%) and the most common organism cultured from the wound was Pseudomonas (50%). The most common additional procedure done was wound debridement. The mortality rate was 10% and the mean duration of hospital stay was 23 days. Conclusion: In contrast to declining rates of trauma-related and cancer-related amputations, we found evidence of a significant increase in the incidence of amputations due to diabetic foot syndrome. Overall, the risk of amputations increased with age. This was true for all etiologies and for both sexes. Males with an average age of 50 years are generally at higher risk for limb loss than women.