The postoperative environment of the amputation stump

Murdoch, George

doi:10.3109/03093648309166977

Cited by 4 publications

(1 citation statement)

References 13 publications

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“…If oedema is permitted to develop interstitial pressure may rise sufficiently to depreciate an already precarious blood supply. This subject is discussed by Murdoch (1983) with a personal recommendation for the use of the rigid cast and controlled environment treatment.…”

Section: Stump Environmentmentioning

confidence: 99%

Amputation revisited

Murdoch

1984

Prosthetics &Amp; Orthotics International

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IntroductionThis lecture was created to honour our founder President Knud Jansen. In New York the Knud Jansen lecture was presented by Charles Radcliffe (1977) and in Bologna by Ernst Marquardt (1980; 1981). The author is very conscious of the honour paid to him and of the distinguished company he joins.Knud was a fine surgeon and a great teacher. Moreover, with his vast knowledge of the literature always presented his material against a historical backcloth. It is therefore, the authors intention to present the subject of amputation surgery in the same way under the following headings: Epidemiology Amputation levels Pre-operative phase Anaesthesia Amputation procedure Stump environment Individual amputations Rehabilitation and prosthetic fitting EpidemiologyIn ancient times, so far as can be seen from archaeological remains and such pictures that exist, amputation was usually the result of unspecified gangrene or trauma. It might have been accidental or from fighting, was occasionally associated with practices in magic, with ritual sacrifice or with punishment: indeed, to this day in some parts of the world the ablation of one or both hands is still used as a punishment for theft. In the Middle Ages huge numbers of

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Section: Stump Environmentmentioning

confidence: 99%

Amputation revisited

Murdoch

1984

Prosthetics &Amp; Orthotics International

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Ward management

Ham¹,

Cotton²

1991

Limb Amputation

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Incidence and Risk Factors of Falling in the Postoperative Lower Limb Amputee While on the Surgical Ward

Lam

Nettel-Aguirre

et al. 2010

PM&R

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Objective To determine the incidence and risk factors of falling among amputees during the postoperative time on the surgical ward. Design Retrospective cohort. Setting Three tertiary acute care hospitals. Patients Subjects aged 18 years or older undergoing either a primary or revision amputation at the transtibial, knee disarticulation, or transfemoral levels. Subjects were excluded if they underwent bilateral amputations. A total of 466 charts were identified, and 370 subjects were included in the analysis. Main Outcome Measurements All outcome measurements were devised before data collection. The primary outcome variable was the presence of at least one fall. Details regarding falls, including the date, time, and location of the first fall, were recorded. In addition, the total number of falls and any associated injuries were documented. Secondary outcome variables included type and number of medical comorbidities, cognitive deficits, and regular use of specific medications. Results Sixty‐one of 370 subjects fell at least once, giving an incidence of 16.5% (95% confidence interval [95% CI] 12.7%‐20.3%). No difference was noted between the fall and no fall groups for gender, mean age, number of regular medications, and number of medical comorbidities. The fall group demonstrated a significantly longer length of stay (difference of means 32.5 days, 95% CI 17.4‐47.5, P < .001). Injuries were sustained in 60.7% of those who fell. Multiple logistic regression analysis identified the major risk factors for falling as dysvascular etiology (odds ratio [OR] 2.418, 95% CI 1.043‐5.606), transtibial level (OR 2.127, 95% CI 1.050‐4.309), and right‐sided amputation (OR 1.933, 95% CI 1.073‐3.483). Conclusions Falls and associated injuries occur commonly in the postoperative lower limb amputee on the surgical ward. Risk factors for falling include dysvascular etiology, transtibial level, and right‐sided amputation. Further studies are required to characterize the mechanisms of falling in this patient population and to develop appropriate fall‐prevention strategies.

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The postoperative environment of the amputation stump

Cited by 4 publications

References 13 publications

Amputation revisited

Amputation revisited

Ward management

Incidence and Risk Factors of Falling in the Postoperative Lower Limb Amputee While on the Surgical Ward

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