Amputation for vascular disease: The experience of a peripheral vascular unit

Abstract

Summary One hundred and forty-five lower limb amputations were performed on 133 patients over a 3 1/2 year period with a hospital mortality of 15 per cent. The mean age of the amputees was 72·2 years (range 43–90 years). The most common site of amputation was below the knee (42 per cent). Failure to obtain primary healing of the stump occurred in 20 per cent of patients and proximal reamputation was required in 8·3 per cent of patients. The ankle systolic blood pressure was not found to be of value in predicting those below-knee amputation stumps which would fail to heal. Accumulated survival figures showed that 45 per cent of amputees died within 2 years of amputation and only 25 per cent were alive at the end of 4 years. The survival of diabetic amputees was significantly worse than that of non-diabetic amputees. Sixty-nine per cent of amputees were admitted to a special rehabilitation unit. At a mean of 2 1/2 years after amputation, 95 per cent of surviving amputees had been successfully integrated back into the community. Seventy-five per cent of amputees who had been fitted with a prosthesis made regular daily use of it but only 50 per cent were mobile beyond their own home. Progression of generalized vascular disease was the most common cause of restricted mobility. As the life expectancy of most amputees is limited every effort must be made to avoid any delay in their recovery and rehabilitation.