Approaches to Treatment of Wounds After Below- and Above-the-Knee Amputations: A Case Series

Despite advances in healing wounds, lower extremity amputations remain common. Typically, the most common cause of lower extremity amputations is peripheral arterial disease or diabetes mellitus. In addition, war-related wounds in recent years have led to an epidemic of lower extremity amputations in Europe and Asia. Postamputation wound complications are common, and these wounds have unique characteristics. Yet, currently, there are no treatment algorithms addressing postamputation wounds. The author presents 9 cases of postamputation wound complications that occurred between 2019 and 2023 and describes various approaches used to facilitate postamputation wound closure. Two stump wounds were related to above-the-knee amputations, and 7 were due to below-the-knee amputations. The average wound depth was 2.1 cm. Four wounds were tunneled. The case series demonstrates typical challenges and describes treatment modalities needed for wound closure, including 2 innovative techniques, a modified Unna boot and "soap scrap," which have proven to be helpful in healing postamputation wounds.