scholarly journals The eventual outcome of patients who had lower limb amputations due to peripheral vascular disease at Pelonomi Hospital, Bloemfontein

2017 ◽  
Vol 59 (2) ◽  
pp. 47
Author(s):  
C De Klerk ◽  
G Du Plessis ◽  
J J Fourie ◽  
A O'Neill ◽  
S J A Smit ◽  
...  
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Lower Limb ◽  
Limb Amputation ◽  
High Morbidity ◽  
Peripheral Vascular ◽  
Contact Information ◽  
Study Population ◽  
One Year

Background: Peripheral vascular disease (PVD) presenting with irreversible lower limb pathology has a high morbidity and mortality rate. This study aimed to determine the outcome of patients who underwent lower limb amputations (LLAs) because of PVD at Pelonomi Hospital, Bloemfontein, 2008–2011. Methods: Prospective data collection of a retrospective cohort study group was performed. Included were patients with PVDinduced LLAs. Demographic and contact information was collected from Meditech. Living status (alive or dead) was determined using the Department of Home Affairs database and interviews with relatives. Results: Of the study population (n = 224), 119 had contact information. Data of 158 people were available to determine living status: 71.5% had died by follow-up in 2014. Forty-nine interviews were possible, 31 patients had died, with cause of death reported to be primarily vascular related. The cumulative mortality showed that 16.1% died within a month and 48.4% within one year post-amputation. Among the 18 living amputees, 50.0% became unemployed, 77.8% used wheelchairs, 11.1% used crutches and 11.1% a prosthesis. Conclusion: Lower limb amputation due to PVD is indicative of a poor prognosis. In our study only 28.5% of patients survived 3–6 years post-amputation. Restoration to ideal mobility was achieved in a minority of cases. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.12481450

scholarly journals Phantom Pain in Major Lower Limb Amputation: Primary Ligation Cauterization vs Traction Neurectomy

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Ahmad Redzuan Arshad ◽  
Nazri Mohd Yusoff
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Phantom Pain ◽  
Peripheral Vascular ◽  
Primary Amputation ◽  
Group A ◽  
Group B

Introduction: Phantom Limb Pain (PLP) is haunting amputees in silent. Neuroma hyperexcitability is one of the popular peripheral theories which can be addressed during primary amputation by orthopaedic surgeons. There was no study comparing type of neurectomy association with PLP. The objective was to compare the occurrence of PLP between conventional and alternative techniques of neurectomy in major lower limb amputations. Materials and Methods: A prospective, randomized, interventional study was conducted involving 98 patients in Hospital Kuala Lumpur requiring major lower limb amputation due to diabetic complication, tumor and trauma from October 2016 to June 2017. Patients were evenly randomized into two groups; Group A: conventional traction neurectomy (CTN) and Group B: ligation and cauterization neurectomy (LCN). End point of the study was the outcome of PLP which was assessed clinically at post-operative day 3, 14 and 6-month. Results were analyzed using univariate and multivariate simple logistic regression. Results: There were have 47 and 46 patients in Group A and B respectively. Of these, 70.2% in Group A (n=33) and 28.3% in Group B (n=13) end up with PLP (p<0.001). Sixty nine percent of patients who underwent amputation above knee level (n=20) suffered from PLP (p<0.05). Group B patients had higher mean PLP pain score (3.31 and 2.94) but it was not statistically significant. 69.6% of patients with pre-operative pain (n=32) and 43.5% with peripheral vascular disease (n=20) developed PLP (p<0.05). Conclusion: LCN has 0.1 chance to develop PLP compared to CTN. Other significant factors in those who developed PLP include levels of amputation, pre-operative pain and peripheral vascular disease. LCN should be considered in primary amputation.

Relationship of severity of lower limb peripheral vascular disease to mortality and morbidity: A six-year follow-up study

1989 ◽  
Vol 9 (5) ◽  
pp. 0691-0697 ◽  
Author(s):  
Mary A. Howell ◽  
Mary Paula Colgan ◽  
Richard W. Seeger ◽  
Don E. Ramsey ◽  
David S. Sumner
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Lower Limb ◽  
Peripheral Vascular ◽  
Mortality And Morbidity ◽  
Follow Up Study ◽  
Relationship Of

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).

scholarly journals An exploratory phenomenological study exploring the experiences of people with systemic disease who have undergone lower limb amputation and its impact on their psychological well-being

2014 ◽  
Vol 40 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Elaine D Washington ◽  
Anita E Williams
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Lower Limb ◽  
Chronic Condition ◽  
Well Being ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Peripheral Vascular ◽  
Psychological Well Being ◽  
Over Time

Background: Amputation is a life-changing event accompanied by challenges for the affected person with time-dependent depression often used to quantify its level of impact on their psychological well-being. There are varied factors that contribute to this and its persistence. The aim of this study was to explore the experiences over time of people with diabetes and/or peripheral vascular disease following an amputation and the impact on their psychological well-being. Objectives: To develop an understanding of the experience of living with an amputation and a chronic condition in order to help clinicians identify those in need of counselling support. Study design: A qualitative study utilising an iterative approach in line with the philosophy of interpretive phenomenology. Methods: Six participants who had experienced a lower limb amputation associated with peripheral vascular disease/diabetes were interviewed on two occasions (baseline and 4 months). An interpretative phenomenological approach was utilised for both data collection and analysis. Results: For these participants, amputation was part of the chronology of their chronic disease. It was the individual’s variable experience of health which impacted their psychological well-being rather than the length of time since amputation. Conclusions: The multivariable experience of amputation means that individually tailored counselling/psychological support is recommended. Clinical relevance An understanding of how the experience of living with an amputation and a chronic condition may change over time will help clinicians to identify the ongoing need for counselling support.

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