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BACKGROUND Technical advances have been made in reconstructive diabetic limb salvage modalities. It is unknown whether these techniques are widely used. This study seeks to determine the role of patient- and hospital-level characteristics that affect use. METHODS Admissions for diabetic lower extremity complications were identified in the 2012-2014 National Inpatient Sample(NIS) using ICD-9-CM diagnosis codes. The study cohort consisted of admitted patients receiving amputations, limb salvage without flap techniques, or advanced limb sa