D58. A Comparative Analysis of Patient-reported Outcomes Following Free Tissue Transfer, Partial Foot Amputation, and Below-knee Amputation in High-risk Limb Salvage Patients

PURPOSE: Patient-reported outcome measures (PROMs) for chronic LE wound interventions are limited. This study aims to compare PROMs in free tissue transfer (FTT), partial foot amputation (PFA), and below-knee amputation (BKA) for chronic LE wounds. METHODS: PROMs were distributed to adult chronic LE wound patients between June 2022 and June 2023. 12-Item Short Survey (SF-12), PROM Information System Pain Intensity (PROMIS), and Lower Extremity Functional Scale (LEFS) were completed at 1-, 3-, 6-months, 1-, 3-, and 5-years postoperatively. Patient characteristics and amputation details were collected. RESULTS: Of 200 survey sets, 71 (35.5%) underwent FTT, 51 (25.5%) underwent PFA, and 78 (39.0%) underwent BKA. Median postoperative time points of survey completion between FTT (6.8 (23.1)), PFA (11.1 (15.1)), and BKA (6.2 (21.3) months) were comparable (p=0.8672). Most patients were male (n=92, 76.0%). Mean age and BMI were 61.8±12.6 years and 30.3±7.0 kg/m2, respectively. Comorbidities for FTT, PFA, and BKA patients included diabetes mellitus (60.6% vs. 81.6% vs. 67.3%; p=0.165), peripheral vascular disease (48.5% vs. 47.4% vs. 42.3%; p=0.790), and chronic kidney disease (12.1% vs. 28.8% vs. 42.1%; p=0.084). No significant differences were observed between BKA, PFA, and FTT patients in mean overall PROMIS (49.6±14.8 vs. 54.2±11.8 vs. 49.6±13.7; p=0.0976), LEFS (37.5±18.0 vs. 34.6±18.3 vs. 38.5±19.4; p=0.4567), or SF-12 (28.0±8.6 vs. 29.5±2.9 vs. 29.0±4.0; p=0.298) scores. CONCLUSION: Patients receiving FTT, PFA, or BKA for chronic LE wounds achieve comparable levels of function, pain, and QoL. Patient-centered functionally-based surgical management using interdisciplinary care, preoperative medical optimization, and proper patient selection optimizes outcomes.