Amputation for peripheral vascular disease: the case for level selection.
One hundred major lower limb amputations were performed for end stage peripheral vascular disease over a 15-month period. Selection of amputation level was made on the basis of laboratory criteria using skin blood flow and infrared thermography data. Eighty-one amputations were performed at the below-knee level with six failures. This resulted in a final below-knee: above-knee amputation ratio of 3:1. It is clear that there are still many centres in the UK where above-knee amputation is the accepted operation, despite the inherent drawbacks to this procedure. We recommend that more attention is given to achieving higher below-knee amputation rates to improve the chances of amputee mobility and therefore quality of life.
McCollum
P T
PT
Department of Vascular Surgery, Ninewells Hospital, Dundee, UK.
Spence
V A
VA
Walker
W F
WF
D000671:Amputation, Surgical / Q000534:rehabilitation; D003925:Diabetic Angiopathies / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007717:Knee; D007866:Leg / Q000601:surgery*; D011446:Prospective Studies; D012867:Skin / Q000098:blood supply; D013524:Surgical Flaps; D013817:Thermography; D014652:Vascular Diseases / Q000503:physiopathology / Q000601:surgery*; D014945:Wound Healing