Early and Long Term Outcomes Following Long Posterior Flap vs. Skew Flap for Below Knee Amputations
| Autor: | Christopher P. Twine, Hannah S. Jesani, Lara K. Jesani, A. L. Stimpson, Alison Lennon, Stephanie Germain, Brenig L. Gwilym, David C. Bosanquet, Ian Massey |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Time Factors medicine.medical_treatment Artificial Limbs skew flap 030204 cardiovascular system & hematology 030230 surgery Amputation Surgical Surgical Flaps long posterior flap 03 medical and health sciences 0302 clinical medicine Median follow-up Risk Factors Prosthesis Fitting Long term outcomes Medicine Humans Below knee amputation Aged Retrospective Studies Aged 80 and over Leg below knee amputation business.industry Recovery of Function Length of Stay Middle Aged Surgery Treatment Outcome Amputation Cohort Functional status Female Cardiology and Cardiovascular Medicine business Residual limb Cohort study |
| Zdroj: | Jesani, L, Gwilym, B, Germain, S, Jesani, H, Stimpson, A, Lennon, A, Massey, I, Twine, C & Bosanquet, D 2020, ' Early and long-term outcomes following long posterior flap vs. skew flap for below knee amputations ', European Journal of Vascular and Endovascular Surgery . https://doi.org/10.1016/j.ejvs.2020.03.049 |
| ISSN: | 1532-2165 |
| DOI: | 10.1016/j.ejvs.2020.03.049 |
| Popis: | IntroductionA Below Knee Amputations (BKA) can be undertaken using either a long posterior flap (LPF) or skew flap (SF). Data comparing outcomes between the two are scant.ObjectivesThe aim of this study was to compare outcomes between the LPF and SF over a 13-year time period.DesignRetrospective observational cohort study. MethodsConsecutive patients undergoing a BKA with the LPF or SF method during a 13-year period at one hospital were identified. Both techniques were performed regularly depending on tissue loss and surgeon preference. The primary outcome was surgical revision of any kind. Secondary outcomes included revision to above knee amputation (AKA), length of hospital stay (LOS) and mortality. A smaller cohort of patients who were alive and unilateral BK amputees were contacted to ascertain prosthetic use and functional status.Results242 BKAs were performed in 212 patients (125 LPF and 117 SF; median follow up: 25.8 months). Outcomes for the two groups were equivalent for surgical revision of any kind (LPF: 27 vs SF: 31; p = 0.373), revision to an AKA (LPF: 18 vs SF: 14; p = 0.576), LOS (LPF: 29 days vs SF: 28 days; p = 0.827), and median survival (LPF: 23.9 months vs SF: 28.8 months; p = 0.894). Multivariate analysis found amputation type had no effect on any outcome. Functional scores from a smaller cohort of 40 unilateral amputees who were contactable demonstrated improved outcomes with the LPF compared to the SF (p = 0.038).ConclusionsBoth techniques appear equivalent for rates of surgical residual limb failure. Functional outcomes may be better with the LPF. |
| Databáze: | OpenAIRE |
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