Elements of Success After Metatarsectomy Healing of Neuropathic Diabetic Foot Ulcers

Hossein  Hemmati; Behrang  Motamed; Sedighe Masoudi  Taramsari; Mohammad Taghi  Ashoobi; Mohaya  Farzin; Habib Eslami  Kenarsari; Rastin  Hosseinzaeh; Zahra Abbasi  Ranjbar; Milad  Sarafi

doi:10.18502/acta.v62i5.17775

Hossein Hemmati Department of Vascular & Trauma Surgery, School of Medicine, Road Trauma Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
Behrang Motamed Department of Internal Medicine, School of Medicine, Inflammatory Lung Diseases Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
Sedighe Masoudi Taramsari Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran
Mohammad Taghi Ashoobi Department of Vascular & Trauma Surgery, School of Medicine, Road Trauma Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
Mohaya Farzin Department of Physiology, Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
Habib Eslami Kenarsari Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran
Rastin Hosseinzaeh Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran
Zahra Abbasi Ranjbar Department of Internal Medicine, School of Medicine, Inflammatory Lung Diseases Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
Milad Sarafi Department of General Surgery, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/acta.v62i5.17775

Keywords: Diabetic foot neuropathic ulcer; Metatarsal resection; Diabetes

Abstract

Diabetic foot ulcer (DFU) is one of the most significant and destructive complications in diabetic patients. It is not only the main cause of patients' foot amputation but is also related to their mortality rate. The aim of this study was to evaluate the results of metatarsectomy in the recovery of diabetic-resistant foot neuropathic wounds to evaluate its clinical effectiveness. This quasi-experimental, before-and-after study was done on 16 diabetic patients with refractory neuropathic ulcers, who were referred to the vascular surgery ward undergoing metatarsectomy. Patients were followed up for two weeks, one month, and three months after surgery and were evaluated for complete recovery, partial recovery, and no response. Of 16 diabetic patients with 16 refractory diabetics plantar fasciitis, 12 (75%) were male and 4 (25%) were female. The mean age of patients was 56.63. There were 5 patients with type 1 diabetes and 11 patients with type 2 diabetes. 10 patients (62.5%) had the underlying non-diabetic disease. 50% of patients had had a history of amputation. The mean duration of diabetes in 16 patients was 18.06 years. All wounds healed completely with an average healing time of 4 months (100% epithelialization). The results of the present study demonstrate that metatarsectomy can be used as a primary technique for offloading in the treatment of diabetic-resistant neuropathic wounds in the soul instead of non-surgical methods. The results prove that this method with a high recovery rate and significant clinical effectiveness can be used as an effective method in the first line of treatment of diabetic-resistant neuropathic wounds of the sole.