Delayed amputation following trauma increases residual lower limb infection.
INTRODUCTION: Residual limb infection following amputation is a devastating complication, resulting in delayed rehabilitation, repeat surgery, prolonged hospitalisation and poor functional outcome. The aim of this study was to identify variables predicting residual limb infection following non-salv...
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| Format: | Journal article |
| Language: | English |
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2013
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| _version_ | 1826260715658280960 |
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| author | Jain, A Glass, G Ahmadi, H Mackey, S Simmons, J Hettiaratchy, S Pearse, M Nanchahal, J |
| author_facet | Jain, A Glass, G Ahmadi, H Mackey, S Simmons, J Hettiaratchy, S Pearse, M Nanchahal, J |
| author_sort | Jain, A |
| collection | OXFORD |
| description | INTRODUCTION: Residual limb infection following amputation is a devastating complication, resulting in delayed rehabilitation, repeat surgery, prolonged hospitalisation and poor functional outcome. The aim of this study was to identify variables predicting residual limb infection following non-salvageable lower limb trauma. METHODS: All cases of non-salvageable lower limb trauma presenting to a specialist centre over 5 years were evaluated from a prospective database and clinical and management variables correlated with the development of deep infection. RESULTS: Forty patients requiring 42 amputations were identified with a mean age of 49 years (±19.9, 1SD). Amputations were performed for 21 Gustilo IIIB injuries, 12 multi-planar degloving injuries, seven IIIC injuries and one open Schatzker 6 fracture. One limb was traumatically amputated at the scene and surgically revised. Amputation level was transtibial in 32, through-knee in one and transfemoral in nine. Median time from injury to amputation was 4 days (range 0-30 days). Amputation following only one debridement and within 5 days resulted in significantly fewer stump infections (p = 0.026 and p = 0.03, respectively, Fisher's exact test). The cumulative probability of infection-free residual limb closure declined steadily from day 5. Multivariate analyses revealed that neither the nature of the injury nor pre-injury patient morbidity independently influenced residual limb infection. CONCLUSION: Avoiding residual limb infection is critically dependent on prompt amputation of non-salvageable limbs. |
| first_indexed | 2024-03-06T19:10:06Z |
| format | Journal article |
| id | oxford-uuid:1676cc54-25e0-4bfc-a9e2-82142b110c60 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:10:06Z |
| publishDate | 2013 |
| record_format | dspace |
| spelling | oxford-uuid:1676cc54-25e0-4bfc-a9e2-82142b110c602022-03-26T10:31:32ZDelayed amputation following trauma increases residual lower limb infection.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1676cc54-25e0-4bfc-a9e2-82142b110c60EnglishSymplectic Elements at Oxford2013Jain, AGlass, GAhmadi, HMackey, SSimmons, JHettiaratchy, SPearse, MNanchahal, J INTRODUCTION: Residual limb infection following amputation is a devastating complication, resulting in delayed rehabilitation, repeat surgery, prolonged hospitalisation and poor functional outcome. The aim of this study was to identify variables predicting residual limb infection following non-salvageable lower limb trauma. METHODS: All cases of non-salvageable lower limb trauma presenting to a specialist centre over 5 years were evaluated from a prospective database and clinical and management variables correlated with the development of deep infection. RESULTS: Forty patients requiring 42 amputations were identified with a mean age of 49 years (±19.9, 1SD). Amputations were performed for 21 Gustilo IIIB injuries, 12 multi-planar degloving injuries, seven IIIC injuries and one open Schatzker 6 fracture. One limb was traumatically amputated at the scene and surgically revised. Amputation level was transtibial in 32, through-knee in one and transfemoral in nine. Median time from injury to amputation was 4 days (range 0-30 days). Amputation following only one debridement and within 5 days resulted in significantly fewer stump infections (p = 0.026 and p = 0.03, respectively, Fisher's exact test). The cumulative probability of infection-free residual limb closure declined steadily from day 5. Multivariate analyses revealed that neither the nature of the injury nor pre-injury patient morbidity independently influenced residual limb infection. CONCLUSION: Avoiding residual limb infection is critically dependent on prompt amputation of non-salvageable limbs. |
| spellingShingle | Jain, A Glass, G Ahmadi, H Mackey, S Simmons, J Hettiaratchy, S Pearse, M Nanchahal, J Delayed amputation following trauma increases residual lower limb infection. |
| title | Delayed amputation following trauma increases residual lower limb infection. |
| title_full | Delayed amputation following trauma increases residual lower limb infection. |
| title_fullStr | Delayed amputation following trauma increases residual lower limb infection. |
| title_full_unstemmed | Delayed amputation following trauma increases residual lower limb infection. |
| title_short | Delayed amputation following trauma increases residual lower limb infection. |
| title_sort | delayed amputation following trauma increases residual lower limb infection |
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