{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T07:22:22Z","timestamp":1789802542382,"version":"4.0.1"},"reference-count":9,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Trop Doct"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>\n                    Major amputation remains the default response to gas-forming soft tissue infection of the lower limb in diabetic patients across Sub-Saharan Africa, despite its devastating functional and economic consequences in settings with minimal prosthetic services. We report a prospective cohort study of 20 such patients who underwent primary decompressive fasciotomy at a tertiary centre in Dakar, Senegal. Overall limb salvage was achieved in 75% (15\/20), and in-hospital mortality was zero. Among nine patients ultimately requiring amputation, the planned level was downstaged in 78%, including one patient initially assessed for hip disarticulation who underwent lower leg amputation. Preoperative vascular status was the decisive predictor: salvage reached 91% with good arterial perfusion versus 0% in mediacalcosis (M\u00f6nckeberg's arteriosclerosis) (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.01). Therefore, decompressive fasciotomy, being a less invasive, inexpensive, and technically accessible procedure, should precede amputation in every diabetic patient with gas-forming lower limb infection and preserved arterial flow.\n                  <\/jats:p>","DOI":"10.1177\/00494755261446119","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T17:21:36Z","timestamp":1777569696000},"page":"655-661","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Decompressive fasciotomy as a limb-sparing intervention for gas-forming soft tissue infection of the lower limb in diabetic patients: A prospective cohort study of 20 cases from Dakar, Senegal"],"prefix":"10.1177","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3143-875X","authenticated-orcid":false,"given":"Seye","family":"Yacine","sequence":"first","affiliation":[{"name":"Clinical Lecturer \/ Assistant Clinical Lecturer, Department of General Surgery, Centre Hospitalier Abass Ndao, Dakar, Senegal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gueye Mohamadou","family":"Lamine","sequence":"additional","affiliation":[{"name":"Senior Lecturer \/ Assistant Professor, Department of General Surgery, Centre Hospitalier Abass Ndao, Dakar, Senegal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5859-7642","authenticated-orcid":false,"given":"Diop Mouhamadou","family":"Laye","sequence":"additional","affiliation":[{"name":"Resident Physician in General Surgery, Department of General Surgery, Centre Hospitalier Abass Ndao, Dakar, Senegal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tour\u00e9 Alpha","family":"Oumar","sequence":"additional","affiliation":[{"name":"Full Professor of General Surgery, Department of General Surgery, Centre Hospitalier Abass Ndao, Dakar, Senegal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seck","family":"Mamadou","sequence":"additional","affiliation":[{"name":"Full Professor of General Surgery General Surgery, Department of General Surgery, Centre Hospitalier Abass Ndao, Dakar, Senegal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2737-9466","authenticated-orcid":false,"given":"Dieng","family":"Madieng","sequence":"additional","affiliation":[{"name":"Full Professor of General Surgery, Department of General Surgery, Centre Hospitalier Abass Ndao, Dakar, Senegal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"e_1_3_2_2_2","article-title":"Characteristics, prevalence, and outcomes of diabetic foot ulcers in Africa: a systematic review and meta-analysis","volume":"13","author":"Naves C","year":"2018","unstructured":"Naves C, Ugwu E, Lacroix P, et al. Characteristics, prevalence, and outcomes of diabetic foot ulcers in Africa: a systematic review and meta-analysis. PLoS One 2018; 13: e0197676.","journal-title":"PLoS One"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00277-9"},{"key":"e_1_3_2_4_2","unstructured":"Bakker DJ. Clostridial myonecrosis. In: Mathieu D (ed.) Handbook on Hyperbaric Medicine. Dordrecht: Springer 2006 pp.417\u2013436."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.28920\/dhm47.1.24-32"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anaerobe.2011.11.001"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13149-015-0442-5"},{"key":"e_1_3_2_8_2","first-page":"54","article-title":"IDSA Clinical practice guideline for the diagnosis and treatment of diabetic foot infections","volume":"2012","author":"Lipsky BA","year":"2012","unstructured":"Lipsky BA, Berendt AR, Cornia PB, et al. IDSA Clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis 2012; 2012: 54. (12):e132\u2013e173.","journal-title":"Clin Infect Dis"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-009-1521-6"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3266"}],"container-title":["Tropical Doctor"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00494755261446119","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00494755261446119","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00494755261446119","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T06:46:48Z","timestamp":1789800408000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00494755261446119"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1177\/00494755261446119"],"URL":"https:\/\/doi.org\/10.1177\/00494755261446119","relation":{},"ISSN":["0049-4755","1758-1133"],"issn-type":[{"value":"0049-4755","type":"print"},{"value":"1758-1133","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]}}}