Comparison of Outcomes in Below-Knee Amputation between Vascular and General Surgeons

Pei, Kevin Y.; Zhang, Yawei; Sarac, Timur P.; Davis, Kimberly A.

doi:10.1016/j.avsg.2017.11.073

Cited by 6 publications

(2 citation statements)

References 15 publications

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“…3,4 Approximately 70-80% of below knee amputations in the United States, particularly those secondary to peripheral vascular disease and diabetic complications, are performed by vascular surgeons. 5 Below knee amputations performed by vascular surgeons have been associated with fewer postoperative complications, lower revision rates, and decreased length of stay for patients in comparison to those performed by other specialties. 5,6 Previous literature has not explored the differences between vascular surgery and other specialties in neuroma formation and phantom limb pain after lower extremity amputation.…”

Section: Introductionmentioning

confidence: 99%

“…5 Below knee amputations performed by vascular surgeons have been associated with fewer postoperative complications, lower revision rates, and decreased length of stay for patients in comparison to those performed by other specialties. 5,6 Previous literature has not explored the differences between vascular surgery and other specialties in neuroma formation and phantom limb pain after lower extremity amputation. That being said, most amputations today are still performed in largely the same manner as those performed during the Civil War.…”

Section: Introductionmentioning

confidence: 99%

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Targeted muscle reinnervation: A narrative review of a novel tool for the management of neuropathic pathology in major lower extremity amputations

et al. 2022

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Objective The purpose of this narrative review is to provide the vascular surgery community with updated recommendations and information regarding the use of Targeted Muscle Reinnervation (TMR) for both the prevention and treatment of chronic pain and phantom limb pain occurring in patients after undergoing lower extremity amputation for peripheral artery disease. Methods Current available literature discussing TMR is reviewed and included in the article in order to provide a succinct overview on the indications, clinical applications, and surgical technique for TMR. Additionally, early studies showing favorable long-term results after TMR are discussed. Patient consent for publication was obtained for this investigation. Results TMR has been demonstrated to be an effective means of both treating and preventing neuroma-related symptoms including chronic pain and phantom limb pain. It has been proven to be technically feasible, and can help patients to have improved utilization of prostheses for ambulation, which can conceivably lead to a reduction in mortality. Conclusions TMR is an important tool to consider for any patient undergoing lower extremity amputation for a vascular-related indication. A vascular-plastic surgeon dual team approach is an effective means to prevent and reduce neuromas and associated chronic pain in this patient population.

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