Автор |
Senkowsky, Jon |
Автор |
Money, Matthew, K. |
Автор |
Kerstein, Morris, D. |
Дата выпуска |
1990 |
dc.description |
Wound breakdown was assessed in 117 amputations for nonhealing lesions and peripheral vascular closure (χ<sup>2</sup> 10.34). Nonhealing occurred in 10/63 amputations with primary skin closure when compared with those not closed (p < .01). All 54 amputation sites treated by the open technique healed without revision. Of 22 toe amputations, the open technique performed in 14 patients required a mean of nine postoperative days; the closed-toe amputation technique performed in 8 patients needed a mean of 5.8 days; the closed-toe amputation requiring revision needed a mean of 36.3 days. Healing rates were significantly different when the wound was left open versus primarily closed (χ<sup>2</sup> 8.56 p < .01). Nineteen transmetatarsal amputations (TMA) were completed; 10 open TMAs required a mean of twenty-four days; 9 closed TMAs required a mean of fifteen days; and revision a mean of eighteen days. Of 51 below-the-knee amputations (BKA), 20 open BKAs required a mean of thirteen days; 3 closed BKAs required a mean of 18.5 days; and 1 revision required two hundred fifty-eight days postoperatively. Twenty-five above-the-knee amputations (AKA) were performed; the 10 open AKAs required a mean of sixteen days; the 15 closed AKAs required a mean of eleven days. There was no significant difference in healing rates of TMA, BKA, or AKA. Healing rates of toe amputations and amputation overall are, however, significantly different. Closed lower extremity amputation wounds require fewer hospital days than open, except if problems in wound healing require revision. |
Издатель |
Sage Publications |
Название |
Lower Extremity Amputation: Open Versus Closed |
Тип |
Journal Article |
DOI |
10.1177/000331979004100307 |
Print ISSN |
0003-3197 |
Журнал |
Angiology |
Том |
41 |
Первая страница |
221 |
Последняя страница |
227 |
Аффилиация |
Senkowsky, Jon, Tulane University School of Medicine, New Orleans, Louisiana |
Аффилиация |
Money, Matthew, K., Tulane University School of Medicine, New Orleans, Louisiana |
Аффилиация |
Kerstein, Morris, D., Tulane University School of Medicine, New Orleans, Louisiana |
Выпуск |
3 |
Библиографическая ссылка |
Towne JB, Condon RE: Lower extremity amputations for ischemic disease. Adv Surg13:199-227, 1979. |
Библиографическая ссылка |
Warren R., Kihn RB: A survey of lower extremity amputation for ischemia. Surgery63:107-120, 1968. |
Библиографическая ссылка |
Baker WH, Barnes RW: Minor forefoot amputation in patients with low ankle pressure. Am J Surg133:331-332, 1977. |
Библиографическая ссылка |
Barnes RW, Sharrik GD, Slaymaker EE: An index of healing in below-knee amputation: Leg blood pressure by Doppler ultrasound. Surgery79:13-20, 1976. |
Библиографическая ссылка |
Berardi RS, Keonin Y.: Amputations in peripheral vascular occlusive disease. Am J Surg135:231-234, 1978. |
Библиографическая ссылка |
Boeckstyns Meh , Clause MJ: Amputation of the forefoot, predictive value of signs and chemical physiological tests. Acta Orthop Scand 55:224-226, 1984. |
Библиографическая ссылка |
Bone GE, Pomayzil MJ: Toe blood pressure by photoplethysmography: An index of healing in forefoot amputation. Surgery89:569-574, 1981. |
Библиографическая ссылка |
Bossen B., Lithman F.: Amputations in diabetics and non-diabetics in Umea County 1971-1977 . Acta Med Scand 687:95-100, 1984. |
Библиографическая ссылка |
Burgess EM: Amputations. Surg Clin North Am63:749-770, 1983. |
Библиографическая ссылка |
Burgess EM, Romano RC, Zettl TH, et al: Amputations of the leg for peripheral vascular insufficiency . J Bone Joint Surg 53A:874-890, 1971. |
Библиографическая ссылка |
Campbell WB , Monis PJ: A prospective randomized comparison of healing in Gretti-Stokes and through knee amputations. Ann R Coll Surg Engl 68:1-4, 1986. |
Библиографическая ссылка |
Castronuovo JJ, Deane LM, Deterling RA, et al: Below-knee amputation: Is the effect to preserve the knee joint justified?Arch Surg115:1184-1187, 1980. |
Библиографическая ссылка |
Clyne CA, Ryan JW, John HH, et al: Oxygen tension in the skin of ischemic legs. Am J Surg143:315-318, 1987. |
Библиографическая ссылка |
Couch NP, David JK, Tilney NL, et al: Natural history of the leg amputee. Am J Surg133:469-473, 1977. |
Библиографическая ссылка |
Desai Y., Robbs JV, Keinar JP: Staged below-knee amputations for septic peripheral lesions due to ischemia . Br J Surg 73:392-394, 1986. |
Библиографическая ссылка |
Malone JM, Goldstone T.: Lower extremity amputation. In: Vascular Surgery, A Comprehensive Review, ed. 2, ed. by Moore WS. Orlando: Grune and Stratton, 1986, pp 1139-1209. |
Библиографическая ссылка |
Fisher DF, Clagett GP, Fry RE, et al: One-stage versus two-stage amputation for wet gangrene of the lower extremity. A randomized study. J Vasc Surg8:428-433, 1988. |
Библиографическая ссылка |
Wooster DL, Rova JL: Fate of the limb after failed femopopliteal reconstruction. Can J Surg25:393-397, 1982. |
Библиографическая ссылка |
Young AE: Transmetatarsal amputation in the management of peripheral.ischemia . Am J Surg 134:604-607, 1977. |
Библиографическая ссылка |
Effeney DJ, Lin RC, Schecter WJ: Transmetatarsal amputation. Arch Surg112:1366-1370, 1977. |
Библиографическая ссылка |
Hicks L., McClelland RM: Below-knee amputations for vascular insufficiency. Am Surg239:243, 1980. |
Библиографическая ссылка |
Holloway GA , Burgess Elm: Cutaneous blood flow and its relation to healing of below knee amputation. Surg Gynecol Obstet 146:750-756, 1978. |
Библиографическая ссылка |
Holstein P. : Level selection in leg amputation for arterial occlusive disease: A comparison of chemical evaluation and skin perfusion pressure. Acta Orthop Scand 53:821-831, 1982. |
Библиографическая ссылка |
Hunsacher RH , Schwartz JA, Keagy BA, et al: Dry ice cryoamputation: A twelve year experience. J Vasc Surg 2:812-816, 1985. |
Библиографическая ссылка |
Jensen JS, Mandig-Poulsen T., Krasmuk M.: Wound healing complications following major amputations of the lower leg. Prosthet Orthot Int6:105-107, 1987. |
Библиографическая ссылка |
Kacy SS, Wolma FJ, Flye MW: Factors affecting the results of below knee amputation in patients with and without diabetes. Surg Gynecol Obstet155:513-518, 1982. |
Библиографическая ссылка |
Katsmamousis A., Brewster DC, Megerman J., et al: Transcutaneous oxygen tension in selection of amputation level. Am J Surg147:510-517, 1984. |
Библиографическая ссылка |
Larsson Uij, Andersson Ggj: Partial amputation of the foot for diabetic or anteriosclerotic gangrene-results and factors of prognostic value. J Bone Joint Surg60-B:126-130, 1978. |
Библиографическая ссылка |
Lepantulo M. , Isoneimi H., Kyllonen L.: Can the failure of a below-knee amputation be predicted: Predictability of below-knee amputation healing. Ann Chir Gynaecol 76:119-123, 1987. |
Библиографическая ссылка |
Squires TW, Johnson W., Wiedrich WC, et al: Cause of wound complications in elderly patients with above-knee amputation. Am J Surg143:523-527, 1982. |
Библиографическая ссылка |
Young AE, Henderson BA, Coach NP: Muscle perfusion and the healing of below knee amputations. Surg Gynecol Obstet146:533-534, 1978. |
Библиографическая ссылка |
Lindegurd W. , Jonsson B., Lithner F.: Amputations in diabetic patients in Gotland and Umea Counties 1971-1980, Acta Med Scand 687:89-93, 1984. |
Библиографическая ссылка |
Murdoch G.: Levels of amputation and limiting factors. Ann R Coll Surg Engl40:204-216, 1967. |
Библиографическая ссылка |
McIntyre KE , Bailey SA, Malone TM, et al: Gillostone amputation in the treatment of non-salvageable lower-extremity infections. Arch Surg 119:450-453, 1984. |
Библиографическая ссылка |
Nicholas GG , Myers JL, DeMuth WE: The role of vascular laboratory criteria in the selection of patients for lower extremity amputation . Ann Surg 195:469-473, 1982. |
Библиографическая ссылка |
Pollock SB Jr, Ernst CB: Use of Doppler pressure measurements in predicting stress in amputation of the leg. Am J Surg 139:303-306, 1980. |
Библиографическая ссылка |
Porter JM, Barr GM, Taylor LM Jr: Lower extremity amputations for ischemia. Arch Surg 116:89-92, 1981. |
Библиографическая ссылка |
Ratliff DA, Clyne Cac, Chamb Adb, et al: Prediction of amputation wound healing: The role of transcutaneous pO2 assessment. Br J Surg71:219-222, 1984. |
Библиографическая ссылка |
Romano RL, Dugess EM: Level selection in lower extremity amputations. Clin Orthop74:177-184, 1971. |
Библиографическая ссылка |
Wood MR, Hutner GA, Millster SG: The value of revision surgery after initial amputation of an upper or lower level. Prosthet Orthot Int11:17-20, 1987. |
Библиографическая ссылка |
Rosenling N. , Adiarte EB, Leslie J., et al: Mortality factors in major limb amputations for vascular disease: A study of 176 procedures . Surgery 67:437-441, 1970. |
Библиографическая ссылка |
Rush DS, Huston CC, Brows BA, et al: Operative and late mortality rates of above-knee and below-knee amputations. Am Surg47:36-39, 1981. |
Библиографическая ссылка |
Scott TE, Creasy JK, Fontenelle LJ, et al: Factors affecting the results of below knee amputations. Milit Med148:259-260, 1983. |
Библиографическая ссылка |
Sizer JS, Wheelock FC Jr: Digital amputations in diabetic patients. Surgery 72:980-989, 1982. |