Premium
Problems of Lower Extremity Amputation Levels
Author(s) -
Tamai Satoru,
Inoue Yoshinori,
Sugano Norihide,
Hirokawa Masayuki,
Jibiki Masatoshi,
Nakamura Hiroshi,
Nakashima Reiko,
Iwai Takehisa
Publication year - 2005
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/j.1067-1927.2005.130116m.x
Subject(s) - medicine , amputation , arteriosclerosis obliterans , surgery , diabetes mellitus , ischemia , gangrene , endocrinology
Objective: There is no consensus of objective information to determine the indication for lower extremity amputation and the lowest amputation level that will heal. In this report, we studied amputation for the lower extremity ischemia. Objects and Methods: We measured transcutaneous oxygen tension (tcPO2) in seven patients who had have ischemic disease of the lower extremity, two patients were in Buerger's disease and five patients were in arteriosclerosis obliterans (ASO). Of these patients, in regard to complications, four patients had diabetes mellitus (DM) and two patients underwent hemodialysis because of chronic renal failure. Six patients of them were men and only one patient was woman, mean age was 59 years old (25∼76 years old). Results: Two patients who had Buerger's disease underwent primary amputation. All another five patients who had ASO underwent secondary amputation. Selections of lower extremity amputation levels were above‐knee amputations in three patients, below‐knee amputations in two patients and toe amputation in two patients. There were incurable infections in two patients. Conclusions: It is generally said that if patients have had critical limb ischemia without providing hemodynamic improvement, it is necessary for them to be performed lower extremity amputations within 12 months, In concrete terms, segmental Doppler systolic blood pressures are below 50 mmHg and tcPO2 are below 30 mmHg. However in this our study, primary healing rate was 75% when the tcPO2 was above 20 mmHg.