Scoping Review of Approaches to Prevent Lower extremity Reamputation in People with Diabetes

Abstract

Title: Scoping Review of Approaches to Prevent Lower extremity Reamputation in People with Diabetes

Presenter: Nouf Alharbi, University of Southampton

 

Background:

High rates of lower limb amputation in people living with Diabetes is a global health concern. There is substantial reamputation risk following initial limb loss, with 37% of people undergoing reamputation within five years. Despite 85% of diabetes-related amputations being preventable, efforts to support long-term limb preservation following initial amputation remain insufficiently addressed.

Aims:

The scoping review aim is to map and appraise evidence about medical and rehabilitative strategies for lower limb reamputation prevention in people with diabetes and identify evidence gaps .

Methods:

A comprehensive literature search was conducted across MEDLINE, CINAHL, AMED, the Cochrane Library, and ProQuest up to February 2025. Studies involving individuals with diabetes-related lower limb amputation were included if they reported on medical interventions for reamputation prevention. The review followed Arksey and O’Malley’s framework and included critical appraisal using Joanna Briggs Institute tools.

Results:

(1) Electrostimulation, (2) Traditional care strategies, e.g., total-contact casting and neuropathy screening, (3) Behavioural and systemic influences, e.g., poor adherence and fragmented care. Technological and traditional strategies demonstrated preventive, therapeutic potential, however, evidence quality varied. Systemic and behavioural influences were recurrent throughout the data.

Conclusion:

This scoping review summarizes the evidence underpinning preventative strategies for reamputation in PWDs. Attending to person-centred behavioural approaches and integrating technology are potential strategies that could reduce reamputation rates.

References:

Gordon et al (2020);
Lavery et al (2019); 
Feinglass et al (2012);
Presern-Strukelj and Poredos (2002);
Pua et al (2006); 
Tanaka and Ueno (2023)