대한족부족관절학회지 (Journal of Korean Foot and Ankle Society)

  • 제27권2호
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  • Pages.49-54
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  • 2023
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  • 1738-3757(pISSN)
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  • 2288-8551(eISSN)
대한족부족관절학회 (Korean Foot & Ankle Society)
권호 표지
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당뇨족으로 인한 비외상성 하퇴부 절단 환자에서 시행한 절단부 창상의 치유 기간과 Ischemia-Modified Albumin과의 관계

Relationship between Ischemia-Modified Albumin and the Healing Period of Amputation Wounds in Patients with Diabetes Mellitus Following Non-traumatic Below-Knee Amputation

  • 허시영 (동아대학교 의과대학 정형외과학교실) ;
  • 이명진 (동아대학교 의과대학 정형외과학교실) ;
  • 김현준 (동아대학교 의과대학 정형외과학교실) ;
  • 변성빈 (동아대학교 의과대학 정형외과학교실)
  • Si Young Heo (Department of Orthopedic Surgery, Dong-A University College of Medicine) ;
  • Myoung Jin Lee (Department of Orthopedic Surgery, Dong-A University College of Medicine) ;
  • Hyeon jun Kim (Department of Orthopedic Surgery, Dong-A University College of Medicine) ;
  • Sung Bin Byun (Department of Orthopedic Surgery, Dong-A University College of Medicine)
  • 투고 : 2022.10.22
  • 심사 : 2023.05.14
  • 발행 : 2023.06.15
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초록

Purpose: The present study examined the effectiveness of the preoperative ischemia-modified albumin (IMA) levels in predicting the healing period of amputation wounds in patients with diabetes mellitus following a non-traumatic below-knee amputation (BKA). Materials and Methods: This study enrolled 41 diabetic foot ulcer patients who underwent BKA at the authors' hospital diabetic foot center from April 2016 to April 2022. Among the 41 patients, 29 (70.7%) were male and 12 (29.3%) were female. Their mean age was 64.54±11.38 years (41~81 years). The mean follow-up period was 19.48±5.56 weeks (14~48 weeks) after BKA. The patients were divided into two groups (high IMA group and normal IMA group), which evaluated the healing period, wound dehiscence, and revision operation rate using a Fisher's exact test and Mann-Whitney U test. Three orthopedic surgeons performed stump wound evaluation, and they were evaluated as healing when all sutures were fused without oozing. Results: Thirty patients (73.2%) (group A) showed a high level of IMA (median: 91.2 U/mL), and 11 (26.8%) patients (group B) showed a normal range of IMA (median: 82.7 U/mL). In group A, the median period for wound healing took 1.4 weeks longer, which was significant (p=0.001). No statistical relationship was observed between wound dehiscence, revision operation rate, and IMA value. There was no correlation between the other risk factors (estimated glomerular filtration rate, HbA1c) and the wound healing period. Conclusion: Although there was a limitation in using IMA as the sole factor to predict the healing period of amputation wounds in patients after BKA, this study revealed a significant positive correlation between IMA and the period of stump healing after BKA. Therefore, the preoperative IMA levels may help predict the period of stump healing after BKA.

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참고문헌

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