A Comparison of Adverse Short-Term Outcomes Following Forefoot Amputation Based on Subject Height

Kushkaran KaurDepartment of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Rhonda S. CornellDelaware Country Memorial Hospital Center for Wound Healing, Havertown, PA.

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Andrew J. MeyrDepartment of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Abstract

Background: The objective of this investigation was to evaluate adverse short-term outcomes following partial forefoot amputation with a specific comparison performed based on subject height.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was analyzed to select those subjects with a 28805 CPT code (amputation, foot; transmetatarsal) that underwent the procedure with “all layers of incision (deep and superficial) fully closed.” This resulted in 11 subjects with a height ≤60 inches, 202 subjects with a height >60 inches and <72 inches, and 55 subjects ≥72 inches.

Results: Results of the primary outcome measures found no significant differences between groups with respect to the development of a superficial surgical site infection (0.0% vs. 6.4% vs. 5.5%; p=0.669), deep incisional infection (9.1% vs. 3.5% vs. 10.9%; p=0.076), or wound disruption (0.0% vs. 5.4% vs. 5.5%; p=0.730). Additionally, no significant differences were observed between groups with respect to unplanned reoperations (9.1% vs. 16.8% vs. 12.7%; p=0.0630) or unplanned hospital readmissions (45.5% vs. 23.3% vs. 20.0%; p=0.190).

Conclusions: The results of this investigation demonstrate no difference in short-term adverse outcomes following the performance of partial forefoot amputation with primary closure based on subject height. Although height has previously been described as a potential risk factor in the development of lower extremity pathogenesis, this finding was not observed in this study from a large US database.

Corresponding author: Andrew J. Meyr, DPM, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, 148 N. 8th Street, Philadelphia, PA 19107. (E-mail: ajmeyr@gmail.com)