MINOR DIABETIC AMPUTATION IN SOLOMON ISLANDS: A FOUR-YEAR RETROSPECTIVE STUDY benjamin_katz@brown.edu

PE064

MINOR DIABETIC AMPUTATION IN SOLOMON ISLANDS: A FOUR-YEAR RETROSPECTIVE STUDY

7

 

 

 

 

United States

Oral or Poster

Solomon Islands is a Western Pacific nation of 992 islands and 9 provinces. Nearly 1 in 5 adults has type II diabetes, and medical care is limited outside of the capital. Rates of diabetic foot infections are high and often progress to amputation. Major amputations are debilitating, high-risk, and place a significant burden on the family and healthcare system. This study examines the role of minor amputations in limb salvage.

This three-year retrospective study (2020-2022) included patients who underwent minor limb amputations for diabetes-related infections at the National Referral Hospital and Helena Goldie Hospital. Patients were identified from surgical logbooks, and data were collected through chart review under an IRB-approved protocol.

119 patients underwent minor amputation during the study period (61.3% male; median age 53.4). 106 were classified as Ray’s (toe) amputations and 13 were forefoot. Pre-operatively, 17 patients had out-of-range blood pressure (normal range 90-120/60-90 mmHg). Average temperature was 36.8°C, with 41 instances of fever. Blood glucose testing showed uncontrolled BSL in 79 patients (mean pre-op BSL 13.9 mmol/L). Hyponatremia was seen in 55 patients (mean sodium 130.9 mmol/L), and 19 were hyperkalemic (mean potassium 5.1 mmol/L). MCV was out of range in 51 cases. Seven progressed to major amputation. Postoperatively, 26 had fever, five experienced distress, and none had shock or died within 48 hours.

Minor amputations were well tolerated. Successful minor amputation is a vital component of limb salvage in limited-resource settings. Early access to surgical care may reduce incidence of diabetic limb sepsis and major amputation.