Chapter 18 Lower Extremity Foot Ulcers and Amputations in Diabetes

Lower extremity ulcers and amputations are anincreasing problem among individuals withdiabetes. Data from the 1983-90 NationalHospital Discharge Surveys (NHDS) indicate that 6 % of hospitalizations listing diabetes on the discharge record also listed a lower extremity ulcer condition. Chronic ulcers were present in 2.7 % of all hospitalizations that listed diabetes. The average length of stay (LOS) for diabetes discharges with ulcer conditions was 59 % longer than for diabetes dis-charges without them. Clinical epidemiologic studies suggest that foot ulcers precede ~85 % of nontraumatic lower extremity amputations (LEAs) in individuals with diabetes. More than half of lower limb amputations in the United States occur in people with diagnosed diabe-tes, who represent only 3 % of the U.S. population. NHDS data indicate that there were ~54,000 diabeti