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Related Experiment Videos

Type of incision for below knee amputation.

P V Tisi1, M J Callam

  • 1Department of Vascular Surgery, Bedford Hospital, Kempston Road, Bedford, Bedfordshire, UK, MK42 9DJ.

The Cochrane Database of Systematic Reviews
|February 20, 2004
PubMed
Summary

Below knee amputation (BKA) techniques like skew or sagittal flaps offer no advantage over the long posterior flap. A two-stage procedure improves stump healing in wet gangrene cases compared to one-stage BKA.

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Area of Science:

  • Vascular Surgery
  • Surgical Techniques
  • Amputation Management

Background:

  • Below knee amputation (BKA) is often a last resort for critical limb ischemia or diabetic foot sepsis.
  • Optimal surgical techniques for BKA to maximize rehabilitation potential remain unclear.

Purpose of the Study:

  • To compare different BKA surgical techniques.
  • Evaluate outcomes including stump healing, infection, reamputation rates, and prosthetic mobility.

Main Methods:

  • Systematic review of randomized controlled trials comparing BKA incision techniques.
  • Searched Cochrane CENTRAL, MEDLINE, and EMBASE databases.
  • Included studies focused on lower limb ischemia or diabetic foot sepsis.

Main Results:

  • Skew or sagittal flaps for BKA showed no superiority over the long posterior flap technique.
  • A two-stage amputation with initial guillotine amputation improved stump healing in wet gangrene compared to one-stage procedures.

Conclusions:

  • Current evidence suggests BKA technique choice does not significantly impact outcomes.
  • Surgeon preference, based on experience and patient factors, may guide technique selection.

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