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[When is primary amputation of the upper leg indicated?].
1Chirurgische Klinik und Poliklinik, Universitätsklinikum Rudolf Virchow-Charlottenburg, Freien Universität Berlin.
Langenbecks Archiv Fur Chirurgie. Supplement II, Verhandlungen Der Deutschen Gesellschaft Fur Chirurgie. Deutsche Gesellschaft Fur Chirurgie. Kongress
|January 1, 1989
Summary
Patients with arterial occlusive disease may require amputation. Below-knee amputation is preferred when possible, but above-knee amputation is sometimes necessary due to healing complications.
Area of Science:
- Vascular Surgery
- Amputation Techniques
Context:
- Arterial occlusive disease necessitates careful consideration of amputation levels.
- High rates of complications (20-30%) exist for below-knee amputations, including poor wound healing and reamputation.
Purpose:
- To outline the indications for primary above-knee amputation versus more distal amputation levels in patients with arterial occlusive disease.
Summary:
- All patients with arterial occlusive disease are potential candidates for bilateral amputation.
- Infragenual (below-knee) amputation is the preferred surgical level when feasible.
- Primary above-knee amputation is reserved for cases where distal amputation is impossible or offers no patient advantage, requiring individualized assessment.
Impact:
- Informed clinical decision-making regarding optimal amputation level.
- Improved patient outcomes by selecting the most advantageous surgical site.
- Reduced rates of reamputation and associated complications.