Weinstein E S, Livingston S, Rubin J R
Department of Surgery Case Western Reserve University, Cleveland, Ohio.
Am Surg. 1988 Jun;54(6):386-9.
A retrospective analysis of the medical records of 17 consecutive patients undergoing lower extremity amputation and Immediate Postoperative Prosthesis (IPOP) placement for infectious complications of unreconstructable arterial insufficiency was performed. Significant soft tissue infection was present in 13 patients and osteomyelitis in four. The mean patient age was 59.4 years and 13 of 17 patients were diabetic. Fourteen patients underwent below knee and three underwent above knee amputations. Seven patients had undergone previous arterial reconstruction. Thirteen patients had previous ipsilateral amputations, five of which were open guillotine amputations performed between 3 and 7 days prior to definitive surgery. Four individuals (24%) required early removal of the IPOP, two due to patient noncompliance and two due to stump healing complications. Thirteen patients (76%) were successfully treated with IPOP and went on to achieve independent gait within 3 weeks of their definitive amputation.
对17例因不可重建的动脉供血不足的感染并发症而接受下肢截肢和术后立即安装假肢(IPOP)的连续患者的病历进行了回顾性分析。13例患者存在严重软组织感染,4例有骨髓炎。患者平均年龄为59.4岁,17例患者中有13例患有糖尿病。14例行膝下截肢,3例行膝上截肢。7例患者曾接受过动脉重建。13例患者曾有同侧截肢史,其中5例为在确定性手术前3至7天进行的开放式断头截肢。4例患者(24%)需要早期拆除IPOP,2例是由于患者不配合,2例是由于残端愈合并发症。13例患者(76%)通过IPOP成功治疗,并在确定性截肢后3周内实现了独立步态。