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Related Experiment Videos

Selection of amputation level: a review.

S Sarin1, S Shami, D A Shields

  • 1Department of Surgery, University College and Middlesex School of Medicine, London, U.K.

European Journal of Vascular Surgery
|December 1, 1991
PubMed
Summary
This summary is machine-generated.

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Preserving the knee joint during lower limb amputation aids rehabilitation. However, predicting successful below-knee amputation healing remains challenging due to poor wound healing and reamputation rates.

Area of Science:

  • Vascular Surgery
  • Orthopedic Surgery
  • Wound Healing

Background:

  • Below-knee amputation (BKA) offers better outcomes than above-knee amputation (AKA) but is underutilized.
  • High rates of BKA stump complications, including poor healing and reamputation, deter surgeons.
  • Clinical judgment alone is insufficient for predicting BKA stump viability.

Purpose of the Study:

  • To review the evidence for various tests used to predict below-knee amputation stump healing.
  • To assess the utility of commonly available diagnostic tools for surgeons.

Main Methods:

  • Systematic review of existing literature on amputation stump healing prediction.
  • Evaluation of diagnostic tests such as Doppler indices, segmental pressures, skin blood flow, skin perfusion pressure, transcutaneous oxygen levels (TcpO2), and thermography.

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  • Focus on tests readily accessible in surgical settings.

    • Main Results:

    • No single predictive test has achieved widespread acceptance for BKA stump healing.
    • Existing tests show variable reliability and lack of universal validation.
    • Clinical assessment remains the primary, albeit insufficient, method for predicting stump healing.

    Conclusions:

    • Improved methods are needed to accurately predict below-knee amputation stump healing.
    • Further research into reliable, accessible diagnostic tools is crucial for optimizing amputation levels and patient outcomes.
    • Widespread adoption of BKA requires better predictive strategies to mitigate risks.