Management of ischemia of the foot beyond arterial reconstruction

During a 20 year period, the outcome of 719 amputations in 552 patients demonstrates that, in a majority of patients, conservation of the foot or knee can be achieved. Two hundred and eighty-seven local amputations of the foot performed upon 249 patients resulted in satisfactory healing in 167 of the 237 surviving patients, with a hospital mortality of 4.8 per cent. In 246 patients, 277 below knee amputations were performed with healing in 192 of 220 survivors but with a 10.5 per cent hospital mortality. Midthigh amputations were reserved for those patients with quite extensive gangrene and gross ischemia. In 155 such patients, the hospital mortality was almost 30 per cent.