Skew flap versus long posterior flap on below-knee amputation in patients with peripheral vascular disease

2014 ◽  
Vol 13 (2) ◽  
pp. 383-391
Author(s):  
Ahmed Kamal Gabr ◽  
Hossam M. Saleh ◽  
Sherif Moaamen Aboshloaa
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Peripheral Vascular ◽  
Posterior Flap ◽  
Knee Amputation

A reappraisal of a modified through-knee amputation in patients with peripheral vascular disease

2001 ◽  
Vol 182 (1) ◽  
pp. 44-48 ◽  
Author(s):  
David L Cull ◽  
Spence M Taylor ◽  
Steven E Hamontree ◽  
Eugene M Langan ◽  
Bruce A Snyder ◽  
...  
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Peripheral Vascular ◽  
Knee Amputation

THROUGH-KNEE AMPUTATION IN PERIPHERAL VASCULAR DISEASE

The Lancet ◽  
1969 ◽  
Vol 294 (7614) ◽  
pp. 240-242 ◽  
Author(s):  
R.R.S Howard ◽  
J Chamberlain ◽  
A.I.S Macpherson
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Peripheral Vascular ◽  
Knee Amputation

scholarly journals A study on diabetic foot and its association with peripheral artery disease

2017 ◽  
Vol 4 (4) ◽  
pp. 1217 ◽  
Author(s):  
Alli Muthiah ◽  
Ramachandran Kandasamy ◽  
Nagulan S. ◽  
Aruna Madasamy
Keyword(s):  
Diabetes Mellitus ◽  
Vascular Surgery ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Peripheral Artery Disease ◽  
Diabetic Foot ◽  
Peripheral Vascular ◽  
Peripheral Artery ◽  
Knee Amputation ◽  
Artery Disease

Background: Diabetes mellitus is characterized by high blood sugar levels over a prolonged period due to alteration in either the insulin secretion, insulin action, or both. Worldwide, as of the recent 2016 data collected from the World Health Organization (WHO) around 422 million adults have diabetes mellitus which is estimated to almost double by 2030 which is composed of mainly type 2 diabetes (85-90% of all cases). The early detection of peripheral artery disease in asymptomatic patients goes a long way in reduction of major lower limb amputations and mortality. Hence, there is a need for evaluation of peripheral vascular disease in all diabetics, especially those with diabetic foot by formulating effective management protocols, thereby limiting the morbidity, mortality and social costs associated with the disease.Methods: Patients admitted and seen in out-patient department for diabetic foot ulcers between January 2013 and October 2013 in Department of general surgery, vascular surgery and diabetology, Kilpauk Medical College Hospital, Chennai, India were taken for study.Results: 150 cases satisfying the inclusion criteria were taken up for the study from January 2013 to October 2013. Out of 150 patients, 76 patients presented with ulcer in foot, 34 presented with gangrene of toe or foot. After clinical examination it was found that 52 patients had associated neuropathy, 17 patients had ABI less than 0.3 and 39 patients had ABI in between 0.4 and 0.9. Patients with ulcer and gangrene in foot and with ABI less than 0.9 were admitted and evaluated with doppler study of lower limbs. After getting consent, appropriate procedure was done for each patient. Wound debridement was done in 21 cases, toe disarticulation in 12, fore foot amputations in 4, Below knee amputation in 9, above knee amputation in 3. 11 patients were referred to vascular surgery and underwent revascularization procedures (BYPASS).Conclusions: The prevalence of peripheral artery disease in patients with diabetic foot is significantly high i.e. 38 % as per this study. Males have a higher predilection for developing peripheral vascular disease than females. The average age of presentation of PAD in diabetics is 40 -60 years. The most common level of arterial occlusion in PAD associated diabetic foot is femoro-popliteal segment followed by tibial segment.

scholarly journals A Retrospective Review of Risk Factors and Conversion Rate of Transmetatarsal Amputations to Below or Above Knee Amputation

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Jefferson Sabatini ◽  
Susan Odum ◽  
J. Kent Ellington ◽  
Carroll P. Jones ◽  
W. Hodges Davis
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
High Rate ◽  
Peripheral Vascular ◽  
Knee Amputation ◽  
Tobacco Abuse ◽  
History Of ◽  
Transmetatarsal Amputation

Category: Diabetes Introduction/Purpose: Despite the presence of several studies examining the conversion from transmetatarsal amputation (TMA) to a more proximal amputation, few studies identified the possible predictors of failure. The objective of this study is to examine the rate of conversion of transmetatarsal amputation to below or above knee amputation, and to identify the risk factors for conversion. Methods: A retrospective cohort study was performed examining 71 transmetatarsal amputations performed by a single group of foot and ankle subspecialists within a single specialty group between October 1 2005 and August 25 2015. Demographic information and comorbidities were recorded, as were complications, readmission rate, and rate of conversion to a more proximal amputation. Results: Of the 71 patients who underwent transmetatarsal amputation during the study period, 74.7% progressed to a revision amputation or more proximal amputation at a mean of 9.7 months, but a median of only 3.2 months. 87.3% progressed to below knee amputation, 9.9% underwent revision transmetatarsal amputation, and 2.8% received an above knee amputation. Of the patients who progressed to more proximal amputation, 88.2% had diabetes mellitus, 72.4% had a pre-operative ulceration, and 81.7% had peripheral neuropathy. Only 52.7% had diagnosed peripheral vascular disease, 38.1% had a history of renal disease, and 35% were smokers. Conclusion: Transmetatarsal amputation has an extremely high short-term reamputation rate with the vast progressing to a below knee amputation. Comorbidities such as diabetes mellitus, neuropathy, and history of ulceration are often found in these patients, while renal and peripheral vascular disease as well as tobacco abuse are not necessarily present. This high rate of reamputation may bring into question the efficacy of performing transmetatarsal amputation as opposed to a more proximal amputation as a definitive procedure when lower extremity amputation is required.

scholarly journals The influence of smoking on the level of lower limb amputation

1987 ◽  
Vol 11 (3) ◽  
pp. 113-116 ◽  
Author(s):  
C. P. U. Stewart
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
General Population ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Lower Limb ◽  
Limb Amputation ◽  
Peripheral Vascular ◽  
Knee Amputation ◽  
High Incidence

A review of smoking habits of 77 vascular related amputees demonstrated a high incidence of smoking significantly greater for men than in the general population. Male smoking amputees with atherosclerosis related peripheral vascular disease were found to have a high risk of having an above-knee amputation. Those with diabetes mellitus whether male or female, smokers or not, had a significantly greater chance of having a below-knee amputation. Overall, non-smokers were found more likely to have a below-knee amputation than an above-knee (p<0.05).

Through-knee amputation in peripheral vascular disease

2012 ◽  
Vol 12 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Andrew J Jackson ◽  
Gerald Coburn ◽  
David Morrison ◽  
Sarah Mrozinski ◽  
John Reidy
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Peripheral Vascular ◽  
Knee Amputation

A Long Posterior Flap in Below-Knee Amputations for Peripheral Vascular Disease: Rationale and Technique

1998 ◽  
Vol 19 (2) ◽  
pp. 110-112 ◽  
Author(s):  
Arthur Manoli
Keyword(s):  
Diabetes Mellitus ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Peripheral Vascular ◽  
Posterior Flap

Three photographs are presented that illustrate the rationale for the use of the long posterior flap in below-knee amputations for peripheral vascular disease and diabetes mellitus.

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