Clinical outcome of staged surgery after primary amputation for mangled extremity

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Reconstructive Surgery

Background:

• Amputation is a life-saving treatment for mangled extremities, often requiring less treatment time than limb salvage.
• Limited research exists on amputation as a primary treatment.
• This study explores outcomes of staged surgery following amputation.

Purpose of the Study:

• To compare clinical outcomes of initial closure (IC) versus staged surgery (SS) after primary amputation for mangled extremities.
• To evaluate complication rates, hospitalization duration, treatment costs, and functional scores.

Main Methods:

• Retrospective study of 47 patients with mangled extremities undergoing primary amputation.
• Patients divided into initial closure (IC) and staged surgery (SS) groups.
• Assessment of complications (necrosis, infection), re-operations, hospitalization, cost, and functional scores at 1 year.

Main Results:

• The staged surgery (SS) group experienced no postoperative complications.
• The initial closure (IC) group required additional surgeries due to infection and necrosis.
• While overall hospitalization and cost were similar, IC patients needing re-operation had longer stays and poorer functional outcomes.

Conclusions:

• Staged surgery is a safe and definitive treatment for mangled extremities.
• This approach significantly reduces complications such as infection and necrosis post-amputation.
• Staged surgery can lead to better functional recovery by avoiding delayed rehabilitation.