[Advanced stage vasculopathies of the lower extremities. Medical and management aspects in amputees].
OBJECTIVE
The paper reports the experience of an operating unit for the rehabilitation of amputees. The unit includes doctors and physiatrists working at the 6th Division of Internal Medicine and the Centre for Motor Rehabilitation at the "Ospedali Riuniti" in Trieste.


METHODS
Subjects were selected on the basis of their psychophysical characteristics and coexistent pathologies. All subjects took part in a hospitalised rehabilitation programme lasting for 60-90 days. This period was followed by outpatient controls that continued for one year after discharge. Clinical conditions, self-sufficiency and quality of life were monitored and studied using special questionnaires.


RESULTS
Of a total of 45 amputees, 27 were not regarded as suitable and 9 died while in hospital. Eighteen were selected for prosthesis; 14 completed the programme and 11 were followed-up for one year as planned. One patient did not attend the follow-up, 1 patient had a stroke and 1 patient died from myocardial infarction.


CONCLUSIONS
Eleven of the 45 amputees included in the study were successfully treated with prothesis. The medical, nursing and economic commitment appears to have been considerable. The expectations of all subjects were high and remained high during rehabilitation in hospital, but deteriorated rapidly at home with the onset of depressive type symptoms. This may have been due to disappointment following their high expectations and the fact that post-discharge assistance was not always appropriate. The high cost-benefit ratio underlines the importance of the careful selection of candidates for rehabilitation.
Briscik
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VI Divisione di Medicina Generale, Azienda Ospedaliera Ospedali Riuniti, Trieste.
Mosetti
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Ponte
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D000671:Amputation, Surgical / Q000401:mortality / Q000523:psychology / Q000534:rehabilitation*; D001186:Artificial Limbs; D003863:Depression / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000601:surgery*; D008297:Male; D009765:Obesity / Q000209:etiology; D015397:Program Evaluation; D011788:Quality of Life; D014652:Vascular Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D014945:Wound Healing