title: [Multiple amputations due to sepsis: however, functional rehabilitation is possible].
abstract: Three patients had several major amputations because of disseminated intravascular coagulation accompanying purpura fulminans. A 31-year-old woman underwent a transfemoral amputation after a septic shock caused by haemolytic streptococcus A, which led to gangrene. A 57-year-old woman had a bilateral transtibial amputation after pneumococcaemia, and the third patient, a 37-year-old woman, underwent a quadruple amputation following a meningococcal septic shock. The amputations were accompanied by contractures and skin damage due to ischaemic tissue changes. Additionally, cerebral and peripheral nerve dysfunction occurred. An intensive rehabilitation programme led to completely independent functioning with the use of orthotics and prosthetics. By starting a multidisciplinary approach as early as possible impairments can be treated properly and future disabilities minimized.
authors.affiliation: Revalidatiecentrum de Hoogstraat, Utrecht.
authors.forename: H G
authors.initials: HG
authors.lastname: Hacking
authors.forename: B A
authors.initials: BA
authors.lastname: Lo-a-Njoe
authors.forename: J M
authors.initials: JM
authors.lastname: Visser-Meily
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000379:methods* / Q000534:rehabilitation*; D001132:Arm / Q000601:surgery; D001186:Artificial Limbs; D004211:Disseminated Intravascular Coagulation / Q000150:complications / Q000601:surgery*; D005260:Female; D005734:Gangrene / Q000209:etiology; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications*; D007866:Leg / Q000601:surgery; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000150:complications; D017755:Prosthesis Fitting / Q000379:methods; D012772:Shock, Septic / Q000209:etiology; D013290:Streptococcal Infections / Q000150:complications; D016896:Treatment Outcome
vernacular_title: Multipele amputaties wegens sepsis; toch mogelijkheden voor functioneel herstel?