A CROS SECTIONAL STUDY ON RAYS AMPUTATION IN PATIENTS WITH DIABETIC FOOT ULCER IN TERTIARY CENTRE

Abstract

Background: Diabetic foot ulcer (DFU) is one of the most serious complications of diabetes mellitus and remains a leading cause of non-traumatic lower-limb amputation. Ray amputation is an established limb-salvage procedure for patients with localized infection, gangrene, or osteomyelitis. However, postoperative wound healing is influenced by several clinical factors, particularly glycaemic control and vascular status. This study evaluated wound healing outcomes following ray amputation and identified factors associated with postoperative recovery.

Methods: A hospital-based observational cross-sectional study was conducted in the Department of General Surgery, Shri Sathya Sai Medical College and Research Institute, Tamil Nadu, India. A total of 100 adult diabetic foot ulcer patients who underwent ray amputation and attended postoperative follow-up between 3 and 6 months were included. Demographic characteristics, HbA1c category, Doppler vascular status, comorbidities, wound healing status, and recovery duration were recorded. Wound healing was categorized as healed, delayed healing, or non-healed. Data were analysed using SPSS software, and associations between categorical variables were assessed using the Chi-square test. A p-value <0.05 was considered statistically significant.

Results: The mean age of the study participants was 54.07 ± 14.45 years, and 69% were males. Complete wound healing was observed in 42% of patients, delayed healing in 33%, and non-healed wounds in 25%. A highly significant association was observed between HbA1c category and wound healing (p <0.001), with patients having HbA1c <7% demonstrating the highest healing rates, whereas poorly controlled diabetes (HbA1c >8%) was associated with delayed healing and non-healed wounds. Doppler vascular status also showed a significant association with wound healing (p = 0.030), with better healing among patients with normal vascular studies. Mean recovery duration differed significantly among healing groups (p <0.001), measuring 7.62 ± 1.10 weeks in healed wounds, 12.45 ± 1.48 weeks in delayed healing, and 19.40 ± 2.16 weeks in non-healed wounds.

Conclusion: Ray amputation is an effective limb-salvage procedure for diabetic foot ulcer patients. Glycaemic control and vascular status are the strongest predictors of postoperative wound healing. Optimising HbA1c levels, routine Doppler vascular assessment, multidisciplinary diabetic foot care, meticulous wound management, and structured postoperative follow-up may improve healing outcomes, shorten recovery duration, and reduce progression to major lower-limb amputation.