Factors affecting wound healing after major amputation for vascular disease

Outcomes of knee disarticulation and the influence of surgical techniques in dysvascular patients

“…54 Other controversial factors include hemorheology, previous revascularisation and presence of diabetes mellitus. 54 One study found that the type of dressing may not affect KDs as much as TTAs (p = 0.447), but a high number of comorbidities may influence healing as well (p = 0.009). 50 These factors need to be addressed with multivariate analyses for conclusive comparisons of primary healing of KD against other amputation levels.…”

“…1 None of the studies used physiological methods (e.g. systolic/perfusion pressure measurements 54 ) for determining amputation levels; hence, higher reamputation rates of KD compared to TF levels may be due to the fact that many patients were unsuitable for KD in the first instance. In certain studies, 40%–50% of reamputations were also previously failed TTAs, indicating inappropriate amputation level selection.…”

“…Factors affecting wound healing are manifold, such as smoking, malnutrition, absence of demarcation, method of amputation level selection, use of prophylactic antibiotics, surgeon experience, drain usage and type of dressing. 54 Other controversial factors include hemorheology, previous revascularisation and presence of diabetes mellitus. 54 One study found that the type of dressing may not affect KDs as much as TTAs (p = 0.447), but a high number of comorbidities may influence healing as well (p = 0.009).…”

Systematic review describing the effect of early mobilisation after dysvascular major lower limb amputations

“…Thirty-day mortality rates of 30% have been reported (Dillingham et al 2005, Kristensen et al 2012, Fortington et al 2013, with the main causes of death being cardiovascular and respiratory complications. Wound complications resulting in re-amputation at a higher level were found in 20-23% of patients who had undergone transtibial amputations (TTAs) (Eneroth 1999, Dillingham et al 2005.…”

“…), with the main causes of death being cardiovascular and respiratory complications. Wound complications resulting in re‐amputation at a higher level were found in 20–23% of patients who had undergone transtibial amputations (TTAs) (Eneroth , Dillingham et al . ).…”