AMPUTATION LEVEL SELECTION IN THE DIABETIC FOOT

Walking independence in the diabetic patient with gangrene or infectio n can be maintained with a conservative program of distal amputation. Patients are preevaluated for their rehabilitation potential. The biol ogic amputation level (the most distal functional amputation level wit h a reasonable potential to heal) is determined by a measure of vascul ar inflow, tissue nutrition, and immunocompetence. By combining wound- healing potential with rehabilitation potential, one can determine the amputation level that will most likely optimize function.