Pinzur M S, Littooy F, Osterman H, Wafer D
STAMP Center, Edward Hines Jr Veterans Administration Hospital, Maywood, Illinois.
Orthopedics. 1988 Jul;11(7):1051-3. doi: 10.3928/0147-7447-19880701-08.
Two consecutive series of patients undergoing below-knee amputation for peripheral vascular insufficiency were compared relative to the length of acute-care hospitalization and rehabilitation. The residual limb control group was treated with soft-surgical dressings and non-weight bearing ambulation with referral to the amputee clinic when the residual limb wound was "ready." The residual limb experimental group was treated with rigid plaster (cast) dressings with early post-surgical prosthetic limb fitting and progressive weight bearing ambulation. Acute-care hospitalization following amputation surgery averaged 27.7 days in the control group, and 23.7 days in the treated group. Patients were either re-admitted or transferred to a rehabilitation unit where hospitalization averaged 42.9 days in the control group and 14.1 days in the treated group. This resulted in a cost savings of almost $15,000 per patient based on present hospital fees. The results of this study suggest that early post-surgical prosthetic limb fitting not only hastens recovery amputation, but can be safe and cost effective.
对因外周血管功能不全而接受膝下截肢手术的两组连续患者，就急性护理住院时间和康复情况进行了比较。残肢对照组采用软外科敷料治疗，非负重行走，残肢伤口“准备好”时转介至截肢者诊所。残肢实验组采用硬石膏（管型）敷料治疗，术后早期安装假肢并进行渐进性负重行走。截肢手术后，对照组急性护理住院平均为27.7天，治疗组为23.7天。患者要么再次入院，要么转至康复科，对照组在康复科的住院时间平均为42.9天，治疗组为14.1天。根据目前的医院收费标准，这使得每位患者节省了近15,000美元的费用。本研究结果表明术后早期安装假肢不仅能加速截肢康复，而且安全且具有成本效益。
