A comparative study on lower extremity amputation (LEA) stump outcome in diabetic and non-diabetic patients in a tertiary care hospital of Raipur City, Chhattisgarh, India


  • P. M. Luka Director Professor and Head of Department, Pt. J.N.M. Medical College and Dr. B.R.A.M Hospital, Raipur, Chhattisgarh
  • Narendra Prasad Narsingh Assistant Professor, Department of Surgery, Pt. J.N.M. Medical College and Dr. B.R.A.M Hospital, Raipur, Chhattisgarh
  • Sumit Agasty Post Graduate Student, Department of Surgery, Pt. J.N.M. Medical College and Dr. B.R.A.M Hospital, Raipur, Chhattisgarh




Lower extremity amputation, Diabetic, Stump complication, Chhattisgarh


Background: Amputation is among the oldest operation known to man. It is the surgical removal of a limb or body part and performed to remove diseased tissue or relieve pain. Amputation is associated with some complications. Infection and failure of stump to heal are major complications. The Diabetes related Lower Extremity Amputation (LEA) is likely to be associated with a worse outcome as compared to the non-diabetic amputations because of the presence of several risk factors which hamper the wound healing process. Amputees with diabetes are more likely to undergo amputation at a younger age and need higher-level amputations when compared with patients without diabetes. With this background, the present study was planned to understand the factors that place diabetic patients at increased risk of amputation in the study area so that further morbidity can be prevented.

Methods: The current prospective study was conducted in the Department of Surgery, Dr. B.R.A.M. Hospital, Pt. JNM Medical College, Raipur (C.G.) India, among 60 patients admitted in the General Surgery wards during January 2013 to August 2014. Study subjects were categorized into those related to diabetes mellitus and those due to other causes. All Investigations relevant to the study (Random blood sugar, Serum albumin, Complete blood count, renal function test and Doppler) were done in all the patients. Postoperatively the cases were examined for various complications of amputation stump in post operative period were noted.

Results: Mean age for diabetic cases was 50 years and that for non-diabetic cases was 47 years. In this study, among the diabetic amputations, 84 % were males and 16 % were females. Total 60 amputations were performed in the study. Stump infection (50 % in diabetics and 29 % in non-diabetics) was the most common stump complication. Followed by wound dehiscence (25 % in diabetics and 11 % in non-diabetics)

Conclusion: Diabetic amputations are at a higher risk of complications. They need to be carefully screened and selected for appropriate level of amputation and watched meticulously for occurrence of complications.



Barber GG, McPhail NV, Scobie TK, A prospective study of lower limb amputations. Can J Surg. 1983; 26:339-41.

Nehler MR, Coll JR, Hiatt WR, et al. Functional outcome in a contemporary series of major lower extremity amputations. J Vasc Surg 2003;38:7.

Kidmas, A.T.; Nwadiaro, C.H. & Igun, G.O. Lower limb amputation in Jos, Nigeria. East Afr Med J. 2004; 81(8):427-9.

Sié Essoh, J.B.; Kodo, M.; Djè Bi Djè, V. & Lambin, Y. Limb amputations in adults in an Ivorian teaching hospital. Niger J Clin Pract. 2009;12(3):245-7.

Phillipo L Chalya et al Major limb amputations: A tertiary hospital experience in northwestern Tanzania. Journal of Orthopaedic Surgery and Research 2012; 7:18.

Lazzarini PA et al. What are the conditions associated lower limb amputation in a major Australian Tertiary Hospital. Journal of Foot and Ankle Research 2012;5:12.

A Ajibade. Indications and Complications of Major Limb Amputations in Kano, Nigeria. Ghana Med J. Dec 2013; 47(4):185-8.

Ogeng’o, J.A.; Obimbo, M.M. & King’ori J. Pattern of limb amputation in a Kenyan rural hospital. Int Orthop. 2009; 33(5):1449-53.

Mohamed Osman Suliman et al. Major lower limb amputation in diabetics Sudan Medical Journal www.Smj. eg.net/journals/pdf/166.pdf -2009.

Belmont PJ Jr, Davey S, Orr JD, et al. Risk factors for 30-day postoperative complications and mortality after below-knee amputation: a study of 2,911 patients from the national surgical quality improvement program. J Am Coll Surg 2011;213:370.

Aragón-Sánchez J et al. In-hospital complications and mortality following major lower extremity amputations in a series of predominantly diabetic patients. Int J Low Extrem Wounds. 2010 Mar; 9(1):16-23.

Coello R, et al Adverse impact of surgical site infections in English hospitals. J Hosp Infect. 2005 Jun; 60(2):93-103.

José Maria Pereira de Godoy et al. Hospital infection after major amputations. Annals of Clinical Microbiology and Antimicrobials 2010;9:15.

Alexandra Alvarsson, Buster Sandgren, Carl Wendel, Michael Alvarsson, Kerstin Brismar. A retrospective analysis of amputation rates in diabetic patients: can lower extremity amputations be further prevented? Cardiovascular Diabetology 2012;11:18.

Cruz CP, Eidt JF, Capps C, et al. Major lower extremity amputations at a Veterans Affairs hospital. Am J Surg 2003; 186:449.

Stone PA, Flaherty SK, Hayes JD, AbuRahma AF. Lower extremity amputation: a contemporary series. W V Med J. 2007 Nov-Dec;103(5):14-8.

Davis BL, Kuznicki J, Praveen SS, Sferra JJ. Lower-extremity amputations in patients with diabetes: pre- and post-surgical decisions related to successful rehabilitation. Diabetes Metab Res Rev. 2004; 20(Suppl 1):S45-S50.

Kacy SS, Wolma FJ, Flye MW: Factors affecting the resuits of below knee amputation in patients with and without diabetes. Surg Gynecol Obstet 1982;155:513-8.

David Tripses, Erich W. Pollak. Risk factors in healing of below-knee amputation. Am J Surg 1981;141(6):718-20.




How to Cite

Luka, P. M., Narsingh, N. P., & Agasty, S. (2017). A comparative study on lower extremity amputation (LEA) stump outcome in diabetic and non-diabetic patients in a tertiary care hospital of Raipur City, Chhattisgarh, India. International Journal of Research in Medical Sciences, 3(6), 1488–1495. https://doi.org/10.18203/2320-6012.ijrms20150173



Original Research Articles