Delayed amputation following trauma increases residual lower limb infection

Jain, Abhilash; Glass, Graeme E.; Ahmadi, Hootan; Mackey, Simon; Simmons, Jon D.; Hettiaratchy, Shehan; Pearse, Michael; Nanchahal, Jagdeep

doi:10.1016/j.bjps.2012.11.026

Cited by 19 publications

(8 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Limb salvage frequently requires multiple surgeries and entails significant perioperative morbidity, pain, high complication rates, and lengthy hospital stays [5,12,23,34]. Furthermore, because functional results of ''late'' amputations may not be as good as primary amputations [10,19], a method that is able to estimate the likelihood of successful limb salvage at or soon after presentation could prove extremely valuable.…”

Section: Introductionmentioning

confidence: 99%

A Model to Predict Limb Salvage in Severe Combat-related Open Calcaneus Fractures

Bevevino

Dickens

Potter

et al. 2014

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

This report demonstrates an artificial neural network was capable of accurately estimating the likelihood of amputation. Furthermore, decision curve analysis suggested the artificial neural network is better suited for clinical use than logistic regression. Once properly validated, this may provide a tool for surgeons and patients faced with combat-related open calcaneus fractures in which decisions between limb salvage and amputation remain difficult.

show abstract

Section: Introductionmentioning

confidence: 99%

A Model to Predict Limb Salvage in Severe Combat-related Open Calcaneus Fractures

Bevevino

Dickens

Potter

et al. 2014

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Giannoudis et al also supported similar, poor outcomes in patients with open tibia fractures and amputations reporting persistent disability in both groups with pain, conduct of usual activities and self-care, and mobility [42]. On counter argument in support of early amputation, other literature supports that delaying amputation in a limb that cannot be reconstructed is associated with high that expected infection rates [43].…”

Section: Discussionmentioning

confidence: 90%

Late amputation may not reduce complications or improve mental health in combat-related, lower extremity limb salvage patients

Krueger

Rivera

Tennent

et al. 2015

Injury

View full text Add to dashboard Cite

“…The management of traumatic amputations should be undertaken in specialist trauma centres that can provide a dedicated orthoplastic team [14] , [15] , [16] , [17] . The QEHB provides a unique centre of experience for treating this injury group.…”

Section: Discussionmentioning

confidence: 99%

“…They also required further revision, with a more proximal amputation and debridement, in 23% of cases. Such serial debridement highlights the level of contamination and the adoption of evidence based orthoplastic principles for their wound care [16] , [17] . The civilian wounds were relatively clean by comparison and thus required fewer debridements.…”

Section: Discussionmentioning

confidence: 99%

Comparing the surgical timelines of military and civilians traumatic lower limb amputations

Staruch

Jackson²,

Hodson

et al. 2016

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

The care and challenges of injured service have been well documented in the literature from a variety of specialities.The aim of this study was to analyse the surgical timelines of military and civilian traumatic amputees and compare the surgical and resuscitative interventions.A retrospective review of patient notes was undertaken. Military patients were identified from the Joint Theatre Trauma Registry (JTTR) in 2009. Civilian patients were identified using the hospital informatics database. Patient demographics, treatment timelines as well as surgical and critical care interventions were reviewed.In total 71 military patients sustained traumatic amputations within this time period. This represented 11% of the total injury demographic in 2009. Excluding upper limb amputees 46 patients sustained lower extremity amputations. These were investigated further. In total 21 civilian patients were identified in a 7-year period.Analysis revealed there was a statistically significant difference between patient age, ITU length of stay, blood products used and number of surgical procedures between military and civilian traumatic amputees. This study identified that military patients were treated for longer in critical care and required more surgical interventions for their amputations.Despite this, their time to stump closure and length of stay were not statistically different compared to civilian patients. Such observations reflect the importance of an Orthoplastic approach, as well as daily surgical theatre co-ordination and weekly multi-disciplinary meetings in providing optimal care for these complex patients. This study reports the epidemiological observed differences between two lower limb trauma groups.

show abstract

Delayed amputation following trauma increases residual lower limb infection

Cited by 19 publications

References 18 publications

A Model to Predict Limb Salvage in Severe Combat-related Open Calcaneus Fractures

A Model to Predict Limb Salvage in Severe Combat-related Open Calcaneus Fractures

Late amputation may not reduce complications or improve mental health in combat-related, lower extremity limb salvage patients

Comparing the surgical timelines of military and civilians traumatic lower limb amputations

Contact Info

Product

Resources

About