Affiliation:
1. Vascular Service, Department of Surgery, University of Natal, Durban, South Africa
Abstract
Abstract
Preservation of the knee joint is of paramount importance in lower limb amputation for ischaemia. Clinical predictors of healing are unreliable in patients with septic peripheral lesions due to ischaemia. Seventy-three patients in whom a below-knee amputation was considered likely to heal, based on the temperature and appearance of the skin and bleeding from skin and muscle flaps, were divided into two groups. Twenty-nine (Group A) had a primary below-knee (BK) amputation at the site of election with delayed primary skin closure, while 44 patients (Group B) initially had a guillotine BK amputation below the site of election, with elective amputation at the appropriate level once infection had been eradicated (4–5 days later). The groups were similarly matched with regard to level of occlusive arterial disease, nature of ischaemic lesions and operative risk factors. There was no significant difference in the overall operative mortality in Group A (6.7 per cent) compared with Group B (11.4 per cent) (P > 0.05). There was a significantly higher above-knee revision rate in Group A survivors (33.3 per cent) compared with Group B (7.7 per cent) (P < 0.01) due to non-viability and uncontrolled sepsis of the BK amputation site. The presence or absence of a palpable femoral or popliteal pulse had no significant influence on healing in either group.
Publisher
Oxford University Press (OUP)
Reference5 articles.
1. Clinical predictors of below knee stump healing following amputation for ischaemia;Robbs;S Afr J Surg,1982
2. Antibiotic prophylaxis in amputations (debridement) with or without arterial reconstruction for septic ischaemic lower limb lesions;Robbs;S Afr Med J,1981
3. Perioperative antibiotic cover in amputations using an amoxycillin-clavulanic acid combination;Huizinga;S Afr Med J,1982
4. Oxygen tension on the skin of ischemic legs;Clyne;Am J Surg,1982
5. Prediction of amputation wound healing: the role of transcutaneous pO2 assessment;Ratcliff;Br J Surg,1984
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