[Amputation of ischaemic extremities--a vascular surgeon's point of view]

The amputation surgery being one of the oldest branches of surgery itself is often times discredited since amputations are frequently considered as a result of failure of alternative therapy options. Worldwide hundreds of thousands amputations are performed annually even though especially in vascular surgery great progress in revascularisation techniques and abilities has been made. Presumably due to rising of life expectancies and increase of diabetes mellitus the number of amputations will in future even rise. Peripheral artery disease and diabetes mellitus which are often associated with a high comorbidity are the most common causes of critical limb ischemia and amputations of the lower extremity. Complications after major amputations like wound infection, development of phantom pain, severe mental distress, myocardial infarction or stroke are frequent. Survival one year after amputation range from 30-50%. The patient collective of amputees is a large group with a high degree of comorbidity in need of special attention and care. The level of amputation ( i.e.: above vs. below knee), postoperative complications, early mobilisation and use of prosthesis are important for the postoperative outcome and the amputees further fate. To regain the independence and mobility in the known social surrounding after amputation is often not to achieve but should be the highest aim of the treating persons.