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Plastic Surgical Procedures for Lower Limb Reconstruction at a Tertiary Hospital in Nepal
Mangal Gharti Magar1, Piyush Giri1, Krishna Kumar Nagarkoti1
1Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital, Kathmandu, Nepal.
Insights
This study on lower limb reconstruction found referred patients had longer hospital stays and more surgeries. Trauma and younger age groups experienced the most complications, primarily wound infections.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
- Trauma Care
Background:
- Assessing lower limb reconstruction outcomes is crucial for improving patient care.
- Establishing baseline evidence supports data-driven decision-making in reconstructive surgery.
Purpose of the Study:
- To evaluate outcomes of lower limb reconstruction.
- To identify factors influencing patient recovery and complications.
- To provide evidence for enhancing future treatment strategies.
Main Methods:
- Retrospective analysis of hospital records from January 1 to December 31, 2019.
- Inclusion of all patients treated for lower limb defects at Kirtipur Hospital.
- Univariate and bivariate statistical analyses were performed on collected data.
Main Results:
- 110 patients were included; 66.4% were male, with a mean age of 38.7 years.
- Trauma (69.1%) was the leading cause; skin grafts were the most common procedure (48.5%).
- Wound infections (43%) were the most frequent complication; referred patients experienced longer hospital stays and required more surgeries.
Conclusions:
- Referred patients demonstrated a higher likelihood of multiple surgeries and prolonged hospitalization compared to non-referred patients.
- Infection emerged as the most prevalent complication, predominantly affecting trauma cases and younger individuals.
- Findings highlight the need for targeted interventions for referred and trauma-related lower limb reconstructions.
Background:
This study assessed the lower limb reconstruction outcome so that it will provide a baseline evidence to enable data-driven decision making to improve outcome in the future.
Methods:
In this study, hospital records from 1st January to 31st December 2019 were collected retrospectively. Complete data of all patients' records treated for lower limb defects at Kirtipur Hospital were included and incomplete data were excluded. Univariate and Bivariate analyses were performed Results: In total 110 patients were included in this study with a male predominance of 66.4% (n=73). The mean age of the patients was 38.7 years (+/- 20). The majority of the patients were from outside Kathmandu valley 79.1% (n=87) and referred 55.5% (n=61). The commonest cause of lower limb defects was trauma 69.1% (n=76), the procedure performed was skin graft 48.5% (n=72), and complication was wound infections, 43% (n=13) of total complications. The hospital stay of more than two weeks was more common among the referred patients 63.9% (n=39) as compared to non-referred patients 30.6% (n=15) and trauma etiology 34.2% (n=26) had more complications than other etiology. The mean age of patients with complications (32.4 years) was lower than those without complications (41.1 years). More number of referred patients (n=43) required multiple surgeries than non-referred patients (n=21).
Conclusions:
Referred cases were more likely to have multiple surgeries and a longer hospital stay than non-referred cases. Infection was the commonest complication and the majority of complications were seen in trauma and younger age group.
