Skin Grafts Provide Durable End-bearing Coverage for Lower-extremity Amputations With Critical Soft Tissue Loss

Abstract

Lower-extremity amputations in the presence of soft tissue loss represent an unresolved conundrum because surgeons must consider sacrificing bone length to obtain adequate soft tissue coverage. Local flaps and microvascular soft tissue transfers are established strategies for maintaining residual limb length. However, the use of skin grafts remains controversial due to the presumed inferiority compared with flaps with regard to enabling prosthetic fitting and full weight bearing. The current study was designed to test the hypothesis that split-thickness skin grafts represent a safe and feasible option to preserve bone length in lower-extremity amputations with critical soft tissue loss.

The dangers of lithotomy positioning in the operating room: case report of bilateral lower extremity compartment syndrome after a 90-minutes surgical procedure

“…As most gynecological procedures require a lithotomy position by default, these patients are at particular risk for developing postoperative compartment syndrome, particularly after prolonged surgical procedures lasting beyond 2–4 h [ 4 , 5 ]. Although a rare complication, delayed diagnosis of ACS can lead to irreversible muscle necrosis with the potential for debilitating lower extremity dysfunction and a high risk for requiring delayed lower limb amputations [ 6 , 7 ]. Thus, prompt recognition and surgical intervention are paramount for mitigating this severe postoperative complication [ 8 – 10 ].…”