{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T17:33:16Z","timestamp":1790443996557,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2012,1,23]],"date-time":"2012-01-23T00:00:00Z","timestamp":1327276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>The role of amputation in limb salvage is often poorly defined because the surgeon and the patient often attempt to save all limbs at all costs. The difficulty lies in selecting limb salvage versus early amputation. For the sedentary patient, a poorly functional salvaged limb can provide him\/her with a higher quality of life than he\/she would have with an amputation. For the active patient, early major amputation may offer the best functional outcome. Our experience with diabetic limb salvage over the last 20\u2009years was retrospectively reviewed and compared with the existing literature in an attempt to better understand the role of amputation <jats:italic>versus<\/jats:italic> limb salvage in patients with diabetes. In the process, surgical techniques that we believe optimize foot and leg amputations were reviewed. Utilizing a team approach, limb salvage can yield a 64% ambulation rate and an 80% 2\u2010year survival rate. Below\u2010knee amputation led to a similar ambulatory rate, but the 2\u2010year survival in these patients was 52%. With more severe rear\u2010foot ulcers and osteomyelitis, the ambulatory rate declined with each co\u2010morbity. However, those whose foot was saved had a higher chance of walking than those who underwent amputation. Function and quality of life are the outcomes of interest and may be maximized through either limb salvage or amputation. Our job as physicians is to match the correct solution to the patients' lifestyle and their medical, physical and psychological conditions so they can achieve their desired level of activity as quickly as possible. Level of evidence: IV. Copyright \u00a9 2012 John Wiley &amp; Sons, Ltd.<\/jats:p>","DOI":"10.1002\/dmrr.2236","type":"journal-article","created":{"date-parts":[[2012,1,23]],"date-time":"2012-01-23T13:37:56Z","timestamp":1327325876000},"page":"93-96","source":"Crossref","is-referenced-by-count":87,"title":["Amputation and ambulation in diabetic patients: Function is the goal"],"prefix":"10.1002","volume":"28","author":[{"given":"Christopher E.","family":"Attinger","sequence":"first","affiliation":[{"name":"Center for Wound Healing Georgetown University Hospital  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin J.","family":"Brown","sequence":"additional","affiliation":[{"name":"Center for Wound Healing Georgetown University Hospital  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,1,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/00015458.2002.11679306"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.01.046"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2005.04.015"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2006.12.027"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2007.10.045"},{"key":"e_1_2_6_7_1","volume-title":"Wound healing in open vs. endovascular bypass","author":"Neville R","year":"2010"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000222582.84385.54"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2008.08.022"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(88)90106-1"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2004.11.001"},{"issue":"2","key":"e_1_2_6_12_1","first-page":"96","article-title":"Tendo Achillis procedures for chronic ulcerations in diabetic patients with transmetatarsal amputations","volume":"83","author":"Barry DC","year":"1993","journal-title":"JAMPA"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200309000-00003"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2006.11.005"},{"issue":"1","key":"e_1_2_6_15_1","first-page":"CD003749","article-title":"Type of incision for below knee amputation","author":"Tisi PV","year":"2004","journal-title":"Cochrane Database Syst Rev"},{"issue":"20","key":"e_1_2_6_16_1","first-page":"218","article-title":"Uber amputationsstumpfe","author":"Ertl J","year":"1949","journal-title":"Chirurg"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.01593"},{"issue":"3","key":"e_1_2_6_18_1","first-page":"341","article-title":"Survival following lower\u2010limb amputation in a veteran population","volume":"38","author":"Mayfield JA","year":"2001","journal-title":"Rehabil Res Dev."},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2011.02.001"}],"container-title":["Diabetes\/Metabolism Research and Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fdmrr.2236","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dmrr.2236","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T21:56:31Z","timestamp":1695506191000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dmrr.2236"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,1,23]]},"references-count":18,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2012,2]]}},"alternative-id":["10.1002\/dmrr.2236"],"URL":"https:\/\/doi.org\/10.1002\/dmrr.2236","archive":["Portico"],"relation":{},"ISSN":["1520-7552","1520-7560"],"issn-type":[{"value":"1520-7552","type":"print"},{"value":"1520-7560","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,1,23]]}}}