Weers, Charlotte (2025) FEET: Finding hEaling Effects of Transmetatarsal amputation; a retrospective multicentre cohort study amongst diabetic patients. thesis, Medicine.
Full text available on request.Abstract
Background Transmetatarsal amputation is a procedure to address foot gangrene and infection in the diabetic patient. When successful it maintains a variable portion of the heel and foot, resulting in ambulation and no need for prosthesis. [3,4,6,18,19] However, it is associated with high complication rates and high chance of higher-level re-amputation [22] Main research question What are the healing outcomes amongst diabetic patients that underwent transmetatarsal amputation in Ziekenhuisgroep Twente (ZGT) and Medisch Spectrum Twente (MST)(2013-2023)? We will focus on the following sub-questions: What is the risk of developing complications after transmetatarsal amputation? Complications such as ulcer recurrence, longer hospital stay, debridement necessity and/or the need for a higher-level amputation. Are there predictive factors in biographic or preoperative data (such as existing comorbidities) for negative healing outcomes? Design In this multicenter retrospective cohort study, data will be collected from the electronic patient files system. The study will be performed by analyzing surgical reports and follow-up reports of all diabetic patients that underwent TMA. Non-diabetic patients will be excluded. Primary outcome measures will be healing, complications, ulcer recurrence and need for revision surgery and mortality. Secondary this study will look at predictive factors for negative outcomes in biographic and perioperative data, such as presence of peripheral arterial disease, renal failure and previous surgeries. Results: Our study reports a 47.7% healing rate, 40.9% re-amputation rate, 68.2% infection, 63.6% ischemia, 54.5% dehiscence, and 43.18% mortality after 5 years. Wound dehiscence and prior surgery correlated with healed wounds, while uncontrolled diabetic patients, non-healed wounds, and open wounds tended to require re-amputation. The high complication and re-amputation rate emphasize the need for improved patient selection and postoperative care.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Cate, Drs. W.A. Ten and Zeegers, Dr. A.V.C.M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 22 May 2026 12:31 |
| Last Modified: | 22 May 2026 12:31 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3959 |
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