The greatest fear for patients with diabetes is the loss of their feet. Many studies show that amputation is an even greater fear than death. From the patient perspective, it is therefore important to save as much of the limb as possible to improve quality of life. At the same time, it is important to avoid costly and difficult reamputations. Consequently, the clinical decision to amputate should always be supported by objective data. To date, the best method with most clinical support is a thorough mapping of the lower limb with transcutaneous oxygen (tcpO2 or TCOM), preferably combined with a provocation.
Amputation of a lower limb is the greatest fear among patients with diabetes.
By preserving as much as possible, below the knee or even trans metatarsal, the patient’s likelihood of walking increases.
Reamputations should be avoided due to the increase in cost and risk for the patient.
Failure to heal after an amputation is often due to insufficient perfusion.
tcpO2 can show an objective map over the perfusion of the lower limb to help in determining the ideal level of amputation.
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