A prospective study of lower limb amputations.
Most leg amputations are performed for vascular disease. A mortality of 30% was associated with above-knee amputations in this study. Healing by primary intention took place in 59% of patients, 31% had delayed healing and 10% required a revision. Only 10% of above-knee amputees used a prosthesis and 48% required total bed care. Below-knee amputations in which a rigid dressing was used had slightly better healing than when soft dressings were used but the difference was not significant. The overall reamputation rate was 15%, the mortality was 7.2% and 57% were fully ambulatory with a prosthesis. Amputation at either the transmetatarsal or digital level was carried out in 25% and 80% healed. The mortality was 11%. Clinical observation is still the best determinant of the level of amputation; below-knee amputation should be strived for in every patient who is a candidate for rehabilitation. Use of a rigid dressing is recommended.
D000368:Aged; D000671:Amputation, Surgical / Q000401:mortality / Q000534:rehabilitation*; D000672:Amputation Stumps / Q000628:therapy; D001458:Bandages; D006801:Humans; D007717:Knee; D007866:Leg / Q000601:surgery*; D011446:Prospective Studies; D014945:Wound Healing