McIntyre K E, Bailey S A, Malone J M, Goldstone J
Arch Surg. 1984 Apr;119(4):450-3. doi: 10.1001/archsurg.1984.01390160080016.
Primary definitive amputation performed in the presence of distal-extremity infection carries the risk of wound infection and additional limb loss. We reviewed 75 below-knee amputations performed for nonsalvageable foot infections. Patients were retrospectively divided into two groups: group 1 underwent open ankle guillotine amputation followed by definitive below-knee amputation, and group 2 underwent primary definitive below-knee amputation. In group 1, 97% of patients achieved primary healing after revision, and none required amputation at a higher level. In group 2, 78% of patients achieved primary healing, but 11% required revision of the amputation to the above-knee level. These data supported the following conclusion: guillotine ankle amputation followed by below-knee amputation for the nonsalvageable, infected lower extremity is associated with a significantly lower amputation failure rate than primary definitive amputation.
在存在远端肢体感染的情况下进行一期确定性截肢手术有伤口感染和额外肢体丧失的风险。我们回顾了75例因不可挽救的足部感染而进行的膝下截肢手术。患者被回顾性地分为两组：第1组先进行开放性踝关节断头术截肢，随后进行确定性膝下截肢，第2组进行一期确定性膝下截肢。在第1组中，97%的患者在翻修后实现了一期愈合，且无人需要更高平面的截肢。在第2组中，78%的患者实现了一期愈合，但11%的患者需要将截肢平面翻修至膝上平面。这些数据支持了以下结论：对于不可挽救的感染下肢，先进行踝关节断头术截肢，然后进行膝下截肢，与一期确定性截肢相比，截肢失败率显著更低。
