SURGICAL MORBIDITY AND THE RISK OF AMPUTATION DUE TO INFECTED PUNCTURE WOUNDS IN DIABETIC VERSUS NONDIABETIC ADULTS

We reviewed the hospital course of 77 diabetic and 69 nondiabetic subj ects who had incision, drainage, and exploration of infected puncture wounds of the foot. Diabetics were 5 times more likely to have multipl e operations and 46 times more likely to have a lower extremity amputa tion than nondiabetics. The interval from injury to surgery was signif icantly longer in diabetics than nondiabetics. Total lymphocyte count and hemoglobin, hematocrit, and albumin values were significantly lowe r in diabetics than in nondiabetics. Diabetic amputees had higher prev alences of nonpalpable pulses, nephropathy, neuropathy, and osteomyeli tis as compared with diabetic nonamputees. The neuropathic diabetic fo ot is not protected by pain. When combined with other comorbid factors , this may increase morbidity associated with puncture wounds of the f oot.