Related Experiment Videos
Factors affecting healing of below knee amputation
1Department of Orthopaedic Surgery O, Singapore General Hospital, Singapore.
Singapore Medical Journal
|August 1, 1996
Summary
Diabetic patients undergoing below-knee amputation face stump necrosis risks. Key risk factors include absent popliteal pulse, cardiovascular disease, and poor intraoperative flap bleeding, impacting healing outcomes.
Area of Science:
- Orthopaedic Surgery
- Diabetic Foot Care
- Vascular Surgery
Background:
- Below-knee amputations are common in diabetic patients.
- Stump healing complications, like necrosis, can necessitate further surgical intervention.
- Optimizing stump healing is crucial for patient mobility and quality of life.
Purpose of the Study:
- To evaluate stump healing outcomes after below-knee amputation in diabetic patients.
- To identify risk factors associated with stump necrosis in this patient cohort.
- To inform surgical strategies for improving amputation outcomes.
Main Methods:
- Retrospective review of 60 below-knee amputations in 54 diabetic patients.
- Follow-up period averaged 16.3 months (range 13-24 months).
- Analysis of stump healing, stump necrosis, and associated pre-operative and intra-operative factors.
Main Results:
- Five patients (8.3%) experienced complete stump necrosis requiring above-knee amputation.
- Eight patients (13.3%) had partial stump necrosis needing debridement or secondary procedures.
- Uneventful stump healing occurred in the remaining patients.
Conclusions:
- Absence of popliteal pulse, central cardiovascular disease, and lack of intraoperative skin flap bleeding are significant risk factors for stump necrosis.
- These findings highlight the importance of vascular assessment and surgical technique in diabetic amputations.
- Proactive management of these risk factors may reduce stump healing complications.