title: Stump infections after major lower-limb amputation: a 10-year retrospective study.
abstract: OBJECTIVE
  There is little published data on the diagnostic and therapeutic management of lower-limb stump infections (excluding toe and forefoot amputations).
  
  
  METHODS
  We made a retrospective observational study of 72 patients having undergone a major lower-limb amputation for a vascular or traumatic reason, complicated by post-surgical stump infection, between January 1, 2000 and December 31, 2009.
  
  
  RESULTS
  Stump infection was diagnosed more than 6weeks after amputation in half of the patients. Staphylococcus was the most frequently isolated bacterium. Ultrasonography and CT scan combined with fistulography were useful to confirm the diagnosis and to determine the extension of infection. Thirty-two patients (44%) needed surgical revision in addition to antibiotic treatment. Patients diagnosed with bone infection more frequently required complementary surgery than those with soft tissue infection (P<0.001).
  
  
  CONCLUSIONS
  The optimal management of this type of infection requires obtaining reliable bacteriological documentation (abscess aspiration in case of soft tissue infection or bone biopsy in case of osteomyelitis) to adapt to the antibiotic treatment. The management should be multidisciplinary (orthopedic or vascular surgeons, rehabilitation specialists, and infectious diseases physicians). Most patients may use prosthesis once the infection is treated.
authors.affiliation: Service de maladies infectieuses et tropicales, hôpital Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France. Electronic address: herve.dutronc@chu-bordeaux.fr.
authors.forename: H
authors.initials: H
authors.lastname: Dutronc
authors.forename: A
authors.initials: A
authors.lastname: Gobet
authors.forename: F-A
authors.initials: FA
authors.lastname: Dauchy
authors.forename: R
authors.initials: R
authors.lastname: Klotz
authors.forename: C
authors.initials: C
authors.lastname: Cazanave
authors.forename: G
authors.initials: G
authors.lastname: Garcia
authors.forename: S
authors.initials: S
authors.lastname: Lafarie-Castet
authors.forename: T
authors.initials: T
authors.lastname: Fabre
authors.forename: M
authors.initials: M
authors.lastname: Dupon
mesh_terms: D000038:Abscess / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000671:Amputation, Surgical / Q000534:rehabilitation; D000672:Amputation Stumps / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery; D001186:Artificial Limbs; D060085:Coinfection; D003131:Combined Modality Therapy; D017577:Cutaneous Fistula / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D003646:Debridement; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007866:Leg / Q000601:surgery*; D007871:Leg Ulcer / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000601:surgery; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D018461:Soft Tissue Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D014463:Ultrasonography; D055815:Young Adult
keywords: Amputation; Infection de moignon; Osteomyelitis; Ostéite; Staphylococcus; Stump infection