The surgical history of the amputated limb according to the indication for revascularization: diabetic foot, acute ischaemia, aneurysmal disease, chronic arterial occlusive disease
| Autor: | Van den Brande P, I. Staelens, Van den Bossche B, Bart Keymeulen, Dimitri Aerden, Patrick Haentjens, E. Debing, von Kemp K |
|---|---|
| Přispěvatelé: | Surgery Specializations, Internal Medicine Specializations, Surgery, Cardio-vascular diseases, Diabetes Pathology & Therapy |
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Ischemia Arterial Occlusive Diseases Revascularization Risk Assessment Amputation Surgical PEOPLE Risk Factors medicine Vascular Patency Humans Aged Retrospective Studies Gangrene Leg business.industry Retrospective cohort study cohort General Medicine medicine.disease Diabetic foot Diabetic Foot Surgery Treatment Outcome Amputation Debridement Cohort Acute Disease Chronic Disease RISK-FACTORS Female business Vascular Surgical Procedures |
| Zdroj: | Acta chirurgica Belgica. 111(6) |
| ISSN: | 0001-5458 |
| Popis: | Background : To investigate whether the indication for the first revascularization (diabetic foot, acute ischaemia, aneurysmal disease, chronic occlusive disease) determines the surgical history and survival time in amputated limbs. Methods : The surgical history of lower extremities amputated between 2002 and 2009 was reviewed for the number of (endo)vascular procedures, minor amputations, wound debridements, complications requiring surgery (acute ischaemia, bleeding, graft infection) and limb survival time (LST). Results : 100 limbs were included in the study. The four groups underwent a similar number of surgical procedures (mean 4.1). Diabetic foot limbs had fewer revascularizations (mean 1.3, p = 0.003) and complications (mean 0.1, p = 0.005), but more minor amputations and wound debridements (mean 1.3, p = 0.002), in a significantly shorter LST (mean 555 days, p = 0.003). Acute ischaemic limbs showed the shortest LST (mean 179 days, p = 0.003) and significantly more complications (mean 0.8, p = 0.005). Limbs initially treated for aneurysmal disease or chronic occlusive disease had the highest number of revascularizations (mean resp.2.7 and 2.6) and the longest LST (mean resp. 1669 and 1459 days, p = 0.001). Limbs with advanced chronic occlusive disease (rest pain or gangrene) presented with fewer revascularisations (mean resp. 2.5 and 1.8, p = 0.01) and a shorter LST (mean resp. 1284 and 794 days, p = 0.004) compared to claudicants. Conclusions : Our study suggests that the surgical history and limb survival in amputated limbs is disease and stage specific, and determined by the indication of the first revascularisation. |
| Databáze: | OpenAIRE |
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