De la Fuente Hagopian Alexa, Farhat Souha, Doval Andres F, Reddy Narainsai K, Yazid Mark M, Echo Anthony
The Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, Houston, Tex.
Texas A&M Health Science Center, Engineering Medicine (EnMed), Houston, Tex.
Plast Reconstr Surg Glob Open. 2023 Apr 14;11(4):e4923. doi: 10.1097/GOX.0000000000004923. eCollection 2023 Apr.
Targeted muscle reinnervation has been adopted as a strategy for the management and prevention of phantom limb pain and symptomatic neuroma formation for patients undergoing lower extremity amputation. The procedure is often performed by surgeons different from those performing the amputation, creating scheduling dilemmas. The purpose of this study was to analyze historic trends in lower extremity amputation scheduling in a single hospital system to evaluate if offering routine immediate targeted muscle reinnervation is practical.
De-identified data over a five-year period for all patients undergoing lower extremity amputation were collected. The data gathered included the specialty performing the amputation, weekly distribution of cases, start time, and end time, among others.
A total of 1549 lower extremity amputations were performed. There was no statistically significant difference in average number of below-the-knee amputations (172.8) and above-the-knee amputations (137.4) per year. Top specialties performing amputations were vascular surgery (47.8%), orthopedic surgery (34.5%), and general surgery (13.85%). No significant difference was noted in the average number of amputations across the week, per year. Most cases started between 6 am and 6 pm (96.4%). The average length of stay after surgery was 8.26 days.
In a large, nontrauma hospital system, most lower extremity amputations are performed during typical working hours and are evenly distributed throughout the week. Understanding peak timing of amputations may allow for targeted muscle reinnervation to be performed concurrently with amputation procedure. Data presented will be a first step to optimizing amputation scheduling for patients in a large nontrauma health system.
靶向肌肉再支配已被用作一种策略，用于管理和预防接受下肢截肢手术患者的幻肢痛和症状性神经瘤形成。该手术通常由与进行截肢手术的外科医生不同的其他外科医生实施，这就产生了手术安排上的难题。本研究的目的是分析单一医院系统中下肢截肢手术安排的历史趋势，以评估提供常规即时靶向肌肉再支配是否可行。
收集了五年期间所有接受下肢截肢手术患者的去识别化数据。收集的数据包括实施截肢手术的专业、病例的周分布、开始时间和结束时间等。
共进行了1549例下肢截肢手术。每年膝下截肢的平均数量（172.8例）和膝上截肢的平均数量（137.4例）之间无统计学显著差异。实施截肢手术的主要专业是血管外科（47.8%）、骨科手术（34.5%）和普通外科（13.85%）。全年每周的截肢平均数量无显著差异。大多数手术在上午6点至下午6点之间开始（96.4%）。术后平均住院时间为8.26天。
在一个大型非创伤性医院系统中，大多数下肢截肢手术在正常工作时间进行，且在一周内分布均匀。了解截肢的高峰时间可能有助于在截肢手术的同时进行靶向肌肉再支配。所呈现的数据将是优化大型非创伤性医疗系统中患者截肢手术安排的第一步。
