Amputation failure experience at Mayo Hospital

Abstract

This observational and noninterventional study was conducted with the objective of calculating the percentage of amputation failure along with identification of causative factors leading to failure and suggestion of measures for their prevention. The research work was carried out on 50 patients undergoing amputation in the Department of Surgery, Mayo Hospital, Lahore: All patients planned for amputation due either to vascular disease, diabetes, trauma, tumor, infection, some neurological cause or congenital problem were above 12 years of age, their thorough assessment and investigations being done prior to surgery. Besides baseline investigations, radiographs of the affected limbs, CT scan and MR scans were carried as and when required. All procedures were performed in accordance with the standard surgical techniques and postoperative course of all amputees was closely observed. It was realized that in six patients, the procedure failed; hence reamputation had to be done at a higher level, thus giving a failure rate of 12%. As regards the causes of failure of amputation, infection of the amputated stump was the commonest (8%) followed by joint contracture (2%) and ischemic necrosis of the stump (2%). It was inferred that certain principles should be strictly adhered to in order to prevent failure of amputation stump (2%). It was inferred that very strict adherence to certain standard surgical principles during the preoperative, peroperative and postoperative settings is required in order to prevent failure of amputation.