Risk of Reulceration and Reamputation after Minor Lower ExtremityAmputation in Type 2 Diabetes: Systematic Review/Meta Analysis

AbstractBackground: Diabetes is one of the most common chronicdiseases in the world. The incidence of diabetes has increasedsteadily in recent years. Type 2 diabetes mellitus has reachedepidemic proportions, affecting 56 million people in Europe (i.e., 8.5% of the adult population).Aim of Study: To establish, through the available literaturethe risk of re-ulceration, re-amputation in diabetic patientsfollowing minor lower limb extremity amputation.Patients and Methods: The following electronic databaseswere searched up to 2019: PubMed, Google Scholar searchengine, Cochrane database of systematic reviews, EMBASEand Science Direct, Wiley Online Library, The Journal ofAnkle and Foot Surgery and Clinical Key database searchingkeywords and terms listed below: “Diabetic foot; Mortality;Toe amputation, Ulcers diabetic foot, Mid-foot amputation,Minor amputation, Peripheral vascular disease”.Results: In our meta-analysis, risk factors for the recurrence of DFUs included male gender, smoking, long duration of diabetes, long duration of past DFUs, plantar ulcers, PAD, and DPN. Also significant differences were found in age. On the other hand there was no relation between BMI and recurrence of DFUs.Conclusion: The results of this meta-analysis showed thatgender, smoking, duration of diabetes, BMI and hypertensionwere risk factors for DFU recurrence. By identifying thesefactors, health care staff could focus on the identified riskfactors for the recurrence; hence, patients with a relativelyhigher risk of DFU recurrence could be treated in a moretimely manner.