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This study is a randomized controlled trial (RCT) to evaluate outcome after toe amputation due to diabetic foot infection. Aim of this RCT is to evaluate wound healing and functional outcome based, whether wound is closed or left open. As a part of this study, emerging technology of thermal imaging is evaluated as a possible tool to predict complication after amputation.
Patients with diabetes undergoing toe amputation due to infection, are recruited for this study. Based on randomization, wound is either closed or left open during the amputation procedure. If primary closure is not possible (e.g. deep abscess) and patient is randomized to closed group, delayed closure is performed when feasible. Patients are followed up in outpatient clinic 3 month after amputation. Primary outcome is wound healing that is evaluated during follow ups in the outpatient clinic. Functional outcome is evaluated with PROM questionnaires preoperatively and during the follow up.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Closed wound | Active Comparator | Wound is closer immediately after amputation (instead healing secondarily) |
|
| Open wound | No Intervention | Wound is left to heal secondarily |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Wound closure | Procedure | Wound is closed or left open to heal secondarily after amputation. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Wound healed | Percentage of patients with completely healed (no dehiscence, necrosis etc.) wound in 3 month control visit | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Complications | Percentage of patients experiencing complication during 3 month follow-up | 3 months |
| Functional outcome: 15D | 15D quality of life questionnaire 3 months after amputation and change compared to preoperative 15D score. 15D is 15 dimensional questionnaire that provides score between 0 and 1 representing health related quality of life (HRQOL). Higher value represents better HRQOL. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Miska Vuorlaakso, PhD | Contact | +3583311611 | miska.vuorlaakso@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Miska Vuorlaakso, PhD | Tampere University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tampere University Hospital | Recruiting | Tampere | Finland |
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| ID | Term |
|---|---|
| D017719 | Diabetic Foot |
| D007239 | Infections |
| ID | Term |
|---|---|
| D003925 | Diabetic Angiopathies |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D016523 | Foot Ulcer |
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| 3 months |
| Functional outcome: TESS | Toronto extremity salvage score (TESS) questionnaire 3 months after amputation and change compared to preoperative TESS score. TESS is contains 30 questions (rated 1-5) measuring activity limitations. TESS result is a percentage of the maximum score, 100 representing normal activity. | 3 months |
| Functional outcome: FHSQ | Foot health status questionnaire (FHSQ) 3 months after amputation and change compared to preoperative FHSQ score. FHSQ consists of 19 questions that ultimately provide score 0-100 higher value representing better foot health status. | 3 months |
| D007871 |
| Leg Ulcer |
| D012883 | Skin Ulcer |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D048909 | Diabetes Complications |
| D003920 | Diabetes Mellitus |
| D004700 | Endocrine System Diseases |
| D003929 | Diabetic Neuropathies |