Over 17% of patients infected with diabetic foot ulcers need amputation within a year

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In the United Kingdom, almost 1 in 6 patients with diabetic foot ulcers requiring antibiotic therapy require lower limb amputation within a year, according to new research.

A multicentre, prospective, observational study, led by the University of Leeds, tracked 299 people who attended a diabetic clinic with an infected foot ulcer. Patients were followed up a year later. At the end of the study period, 45 of the 299 participants (15.1%) had died. More than 17% underwent ipsilateral lower extremity amputation and 6% received revascularisation surgery. The ulcer healed in only 45.5% of participants and recurred in almost 10%.

The incidence of healing was lower when the ulcer had been present for at least 2 mo, and among those with a PEDIS (perfusion, extent, depth, infection, sensation) perfusion grade of ≥2 (HR, 0.37; 95% CI, 0.25-0.55). Participants with a single ulcer on the index foot had a higher incidence of healing than those with multiple ulcers (HR, 1.90; 95% CI, 1.18-3.06).

Foot ulcers affect around a quarter of the 3.3 million people in the United Kingdom living with diabetes. National Institute for Health and Care Excellence puts the annual cost for treating diabetic foot wounds at £650 million.

Co-author, Dr. Michael Backhouse from the University of Leeds, said: "The results of our study are important and should help clinicians caring for patients with diabetes to identify those most at risk for poor outcomes so that we can look to provide further support."