title: Salvage of failed amputation about the hip in peripheral vascular disease by open wound care and nutritional support.
abstract: Five consecutive patients with wound and/or plastic surgical flap failure after hip disarticulation or amputation at the lesser trochanteric transfemoral level were treated with local tissue debridement, open wound management, culture-specific antibiotic therapy, and nutritional supplementation. All of the patients underwent amputation about the hip as a result of ischemic necrosis of the lower extremity. Four of the five patients were able to achieve wound healing by second intention. The fifth patient died 2 months after the surgery. None of the patients required revision surgery. One patient underwent split-thickness skin grafting to minimize the need for continued wound care. Local wound management combined with nutritional support and culture-specific antibiotic therapy is an acceptable alternative to major amputation stump revision in patients with potentially high morbidity who fail to heal after amputation about the hip.
authors.affiliation: Department of Orthopaedic Surgery, Loyola University Medical Center, Maywood, Illinois, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Pinzur
authors.forename: J
authors.initials: J
authors.lastname: Angelats
authors.forename: T
authors.initials: T
authors.lastname: Bittar
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods*; D004188:Disarticulation / Q000009:adverse effects*; D005260:Female; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018529:Nutritional Support / Q000379:methods*; D016491:Peripheral Vascular Diseases / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D013524:Surgical Flaps / Q000009:adverse effects*; D017211:Treatment Failure; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents