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Related Experiment Videos

Amputation for peripheral vascular disease: the case for level selection.

P T McCollum1, V A Spence, W F Walker

  • 1Department of Vascular Surgery, Ninewells Hospital, Dundee, UK.

The British Journal of Surgery
|December 1, 1988
PubMed
Summary
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This study on lower limb amputations found that below-knee amputations, guided by skin blood flow and thermography, led to a 3:1 ratio over above-knee procedures. Prioritizing below-knee amputations can enhance patient mobility and quality of life.

Area of Science:

  • Vascular Surgery
  • Amputation Techniques
  • Patient Outcomes

Background:

  • End-stage peripheral vascular disease (PVD) necessitates major lower limb amputations.
  • Current practices in some UK centers favor above-knee amputations, despite potential drawbacks.

Purpose of the Study:

  • To evaluate the effectiveness of laboratory criteria in selecting amputation levels.
  • To assess the ratio of below-knee to above-knee amputations and its impact on patient outcomes.

Main Methods:

  • One hundred major lower limb amputations were performed over 15 months for end-stage PVD.
  • Amputation level selection was based on laboratory criteria, including skin blood flow and infrared thermography.
  • Data analysis focused on amputation levels and success rates.

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Main Results:

  • Eighty-one (81%) amputations were performed at the below-knee level, with only six failures.
  • This resulted in a below-knee to above-knee amputation ratio of 3:1.
  • A high rate of successful below-knee amputations was achieved.

Conclusions:

  • Laboratory criteria effectively guide the selection of below-knee amputation levels.
  • Increasing below-knee amputation rates can improve amputee mobility and quality of life.
  • A shift towards higher below-knee amputation rates is recommended in centers still favoring above-knee procedures.