Incidence of reamputation and death after gangrene of the lower extremity.

Since 1972 the Danish Amputation Register (DAR) has recorded major amputations in Denmark. The register is based on voluntary detailed reports from surgical and orthopaedic departments. The present investigation is based upon 2029 amputations for arteriosclerotic and diabetic gangrene with an observation period up to 4 years. The incidence of ipsilateral reamputation is high in the immediate postoperative period with 10.4% after one month, 16.5% after three months and 18.8% after six months. Later the incidence is quite low, reaching a total of 23.1% after four years. The risk of contralateral amputation is ever present with an incidence of 11.9% within one year, 17.8% after two years, 27.2% after three years, and finally 44.3% after four years. The mortality after three months is 16.3% and then tapers off to a total of 22.5% after four years. As compared with the normal population a significant over-mortality is seen during the first three months, and an equally significant under-mortality from six months onward during the observation period.