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Updated: Jul 17, 2025

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers
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Burn Center Patients at Risk for Upper Extremity Amputations.

Danielle A Thornburg1, Scott Swanson2, Philomene Spadafore1,2

  • 1Mayo Clinic Arizona, Phoenix, AZ, USA.

Plastic Surgery (Oakville, Ont.)
|September 1, 2023
PubMed
Summary
This summary is machine-generated.

Factors like infections and surgical interventions such as escharotomies and fasciotomies increase the risk of upper extremity amputations in burn patients. These factors also lead to longer hospitalizations and intensive care unit stays.

Keywords:
amputationsburnsnecrotizing soft tissue infectionsskin disordersupper extremity

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Area of Science:

  • Trauma Surgery
  • Burn Care
  • Infectious Diseases

Background:

  • Burn center patients face complex conditions beyond burns, including necrotizing infections and trauma.
  • Limb salvage is not always possible, necessitating amputations for burn patients.
  • Identifying factors predicting amputation risk is crucial for optimizing patient care.

Purpose of the Study:

  • To determine factors predisposing burn patients to extremity amputations.
  • To compare characteristics of patients requiring upper extremity amputation versus those who do not.

Main Methods:

  • Retrospective registry review of burn center patients from 2000-2019.
  • Pair-matched comparison of upper extremity amputee patients (APs) and non-amputees (NAPs) based on age, sex, %TBSA, and injury type/location.
  • Statistical analysis to identify significant differences between groups.

Main Results:

  • Upper extremity amputee patients experienced significantly longer hospitalizations and intensive care unit stays.
  • Amputee patients had a higher incidence of cardiac, renal, and pulmonary comorbidities.
  • Acquired infections, escharotomies, and fasciotomies were significantly more prevalent in the amputee group.

Conclusions:

  • Escharotomies, fasciotomies, and various infections (sepsis, pneumonia, wound, urinary tract) are associated with prolonged hospitalizations.
  • These interventions and complications significantly increase the risk for upper extremity amputations in burn patients.
  • Understanding these risk factors can guide preventative strategies and treatment decisions in burn care.