{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T03:16:31Z","timestamp":1784690191423,"version":"3.55.0"},"reference-count":48,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T00:00:00Z","timestamp":1659052800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>The prevalence of diabetic foot complications is continuously increasing as diabetes has become one of the most important \u201cepidemics\u201d of our time. The main objective of this study was to describe the appropriate surgical intervention for the complicated neuropathic diabetic foot; the secondary goal was to find the risk factors associated with minor\/major amputation and good or adverse surgical outcomes. This is an observational, retrospective study conducted between 1 January 2018 and 31 December 2019, which included 251 patients from the General Surgery Department at the Dr I. Cantacuzino Clinical Hospital in Bucharest with type II diabetes mellitus and neuropathic diabetic foot complications. The surgical conditions identified at admission were the following: osteitis (38.6%), infected foot ulcer (27.5%), gangrene (20.7%), infected Charcot foot (3.6%), non-healing wound (3.6%), necrosis (3.2%), and granulated wound (2.8%). We found that a minor surgical procedure (transmetatarsal amputation of the toe and debridement) was performed in 85.8% of cases, and only 14.2% needed major amputations. Osteitis was mainly associated with minor surgery (p = 0.001), while the gangrene and the infected Charcot foot were predictable for major amputation, with OR = 2.230, 95% CI (1.024\u20134.857) and OR = 5.316, 95% CI (1.354\u201320.877), respectively. Admission anemia and diabetic nephropathy were predictive of a major therapeutical approach, with p = 0.011, OR = 2.975, 95% CI (1.244\u20138.116) and p = 0.001, OR = 3.565, 95% CI (1.623\u20137.832), respectively. All the major amputations had a good outcome, while only several minor surgeries were interpreted as the adverse outcome (n = 24). Osteitis (45.8%) and admission anemia (79.2%) were more frequently associated with adverse outcomes, with p = 0.447 and p = 0.054, respectively. The complicated neuropathic diabetic foot requires a surgical procedure mainly associated with a good outcome.<\/jats:p>","DOI":"10.3390\/life12081156","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T02:06:42Z","timestamp":1659319602000},"page":"1156","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Outcome of Surgical Treatment for the Neuropathic Diabetic Foot Lesions\u2014A Single-Center Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Florin","family":"Bobirca","sequence":"first","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Surgery Department, Dr. Ion Cantacuzino Clinical Hospital, 011437 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0126-0926","authenticated-orcid":false,"given":"Catalin Gabriel","family":"Smarandache","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Surgery, University Emergency Hospital, 050098 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6662-7354","authenticated-orcid":false,"given":"Anca","family":"Bobirca","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Internal Medicine and Rheumatology Department, Dr Ion Cantacuzino Clinical Hospital, 011437 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7053-7530","authenticated-orcid":false,"given":"Cristina","family":"Alexandru","sequence":"additional","affiliation":[{"name":"Internal Medicine and Rheumatology Department, Dr Ion Cantacuzino Clinical Hospital, 011437 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Dumitrescu","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Surgery Department, Dr. Ion Cantacuzino Clinical Hospital, 011437 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0555-526X","authenticated-orcid":false,"given":"Anca Pantea","family":"Stoian","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Diabetes, Nutrition and Metabolic Diseases, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8957-5980","authenticated-orcid":false,"given":"Cristina","family":"Bica","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Diabetes, Nutrition and Metabolic Diseases, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lacramioara Aurelia","family":"Brinduse","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Public Health and Management, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca","family":"Musetescu","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Craiova University of Medicine, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela-Elena","family":"Gheoca-Mutu","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Plastic and Reconstructive Surgery, \u201cProf. Dr. Agrippa Ionescu\u201d Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2687-2611","authenticated-orcid":false,"given":"Sebastian","family":"Isac","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Physiology and Neuroscience, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioan","family":"Ancuta","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Internal Medicine and Rheumatology Department, Dr Ion Cantacuzino Clinical Hospital, 011437 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Volmer-Thole, M., and Lobmann, R. 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