title: Cause of wound complications in elderly patients with above-knee amputation.
abstract: Seventy-six above-knee amputations performed on elderly debilitated patients were reviewed. Fifty-one wounds healed without complications; 25 amputation wounds developed postoperative complications. The quality of the femoral pulse has a significant effect on wound healing after an above-knee amputation. Other significant conditions that appear to influence the frequency of wound complications are hypertension, a failed bypass procedure to the groin, and angiographic evidence of stenosis or occlusion of the common femoral or the profunda femoral artery. Multiple variable analysis suggests a beneficial effect of antibiotics in patients with a diminished or absent femoral pulse. Age, presence of cardiac disease, diabetes, associated diseases and the use of drains have no significant effect on the outcome. Before an above-knee amputation, patients with a diminished femoral pulse should undergo arteriography and perhaps reconstructive surgery. Primary hip disarticulation may be the initial procedure of choice in the presence of multiple risk factors.
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000009:adverse effects*; D000792:Angiography; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004322:Drainage; D005263:Femoral Artery; D006801:Humans; D006973:Hypertension / Q000150:complications; D007717:Knee / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011674:Pulse; D012086:Reoperation; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents