Two-phase amputation among critically ill patients with ischemic gangrene of lower limbs as a way to improve treatment outcome. Cohort study.

摘要: Abstract Background The results of lower limb amputation, especially in critically ill patients with severe endogenous intoxication, sepsis, multi-organ failure and concomitant diseases are still unsatisfactory. Guillotine amputation is a method routinely used to reduce wound complications associated wet gangrene cases diabetic foot, however, it unclear how well could help decrease mortality improve functional outcome when dealing patients. objective the study was estimate effectiveness two-phase urgent low among high risk complications. evaluated terms perioperative mortality, frequency early ultimate level loss. Materials methods Two cohort groups acute were retrospectively matched. Approximately 25.8% from comparison (control) group (N = 240) died without surgery due severity their condition ineffective pre-operative treatment. remaining underwent one-phase high-level after 48–72 h intensive care. experimental consisted 153 who guillotine at part tibia (34.6%), knee disarticulation (32.0%), or open thigh (33.3%), depending on irreversible soft tissue necrosis. reamputation stump shaping performed later health status improved. Results assessment treatment outcomes showed that (i) decreased 48.7 37.9%, (ii) reduced 20.9 11.1%, (iii) improved by saving joint 34.6 versus 4.5% comparison/control group. Conclusion recommended for