Folsom D, King T, Rubin J R
Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Am J Surg. 1992 Oct;164(4):320-2. doi: 10.1016/s0002-9610(05)80896-7.
To study the efficacy of an immediate postoperative prosthesis (IPOP) program, a retrospective review of 167 major lower-extremity amputations was performed. Patient enrollment in the IPOP program was based on the individual's potential for rehabilitation and participation in an aggressive postoperative physical therapy regimen, as determined by the surgeon, prosthetist, physical therapist, and social worker. Indications for amputation were intractable infection and/or severe unreconstructable arterial insufficiency. Sixty-five patients underwent 69 amputations with IPOP (59 below knee; 10 above knee). Successful program completion was defined as independent ambulation and occurred in 86% of those patients enrolled. The average interval from amputation to ambulation was 15.2 days for the below-knee amputees and 9.3 days for the above-knee amputees. Failure to complete the program occurred in 14% of patients and was due to noncompliance, stump infection, stump trauma, and death. The results of this review support the use of IPOP after major lower-extremity amputation.
为研究术后即刻安装假肢（IPOP）方案的疗效，我们对167例下肢大截肢病例进行了回顾性研究。患者入选IPOP方案是基于外科医生、假肢师、物理治疗师和社会工作者确定的个体康复潜力以及参与积极术后物理治疗方案的可能性。截肢指征为顽固性感染和/或严重不可重建的动脉供血不足。65例患者接受了69次IPOP截肢手术（59例膝下截肢；10例膝上截肢）。成功完成方案定义为独立行走，参与方案的患者中有86%实现了这一目标。膝下截肢患者从截肢到行走的平均间隔时间为15.2天，膝上截肢患者为9.3天。14%的患者未能完成方案，原因包括不依从、残端感染、残端创伤和死亡。本回顾性研究结果支持在下肢大截肢术后使用IPOP方案。
