Lower Limb Surgery in Diabetic Patients: Predictors of Poor Wound Healing and Postoperative Outcomes in Two Regional Hospitals of Cameroon

Abstract

Background: Diabetes mellitus (DM) is a chronic metabolic disease strongly associated with impaired wound healing and is a leading cause of non-traumatic lower limb amputations. In sub-Saharan Africa, late presentation and limited resources contribute to poor surgical outcomes. Objective: To assess wound healing outcomes and associated factors among diabetic patients who underwent lower limb surgery at Buea and Limbe Regional Hospitals, Cameroon. Methods: A retrospective study was conducted from January 2018 to December 2022. All diabetic patients who underwent lower limb surgery were included. Data on sociodemographic, clinical, surgical, and outcome variables were collected and analyzed using SPSS v25. Logistic regression identified predictors of poor wound healing. Results: A total of 138 patients were included (mean age: 48.4 years; 71.7% male). Type 2 DM predominated (97.8%). The main comorbidity was dyslipidemia (62.3%). Amputation was the most frequent surgical procedure (70.3%), with above-knee amputations representing 34.1%. Postoperative complications were dominated by infection (50%) and stump edema (18.8%). The overall mortality rate was low (1.4%). Conclusion: Wound healing outcomes in diabetic patients remain poor, marked by high rates of amputation and postoperative complications, despite low mortality. Preventive care, early referral, and multidisciplinary foot-care programs are urgently needed.