[Patients in need for major lower extremity amputations are a challenge]

Area of Science:

• Orthopaedic Surgery
• Vascular Surgery
• Diabetology

Background:

• Major lower extremity amputations are common for end-stage chronic leg ischemia or infected diabetic ulcers.
• Patients often undergo evaluation for revascularization before amputation if unfit for vascular surgery.
• These patients are typically multi-morbid, presenting significant surgical challenges and high mortality risks.

Purpose of the Study:

• To highlight the challenges in managing patients undergoing major lower extremity amputations.
• To emphasize the need for novel management strategies in this high-risk population.
• To advocate for optimized multidisciplinary care regimes.

Main Methods:

• Review of patient cohorts undergoing major lower extremity amputation.
• Analysis of patient comorbidities and surgical outcomes.
• Evaluation of current treatment pathways and outcomes.

Main Results:

• Patients unfit for vascular surgery represent a high-risk group for major lower extremity amputation.
• Multi-morbidity significantly contributes to the challenges and high mortality rates in this population.
• Current approaches may not adequately address the complexities of these patients.

Conclusions:

• Optimized multidisciplinary regimes are crucial for improving outcomes in patients undergoing major lower extremity amputations.
• Further research into novel approaches is warranted to reduce mortality in this vulnerable group.
• Integrated care pathways involving orthopaedic and vascular services are essential.