One-stage versus two-stage amputation for wet gangrene of the lower extremity: A randomized study *

摘要: Although the two-stage amputation technique entails an additional operation, several authors have advocated this approach to deal with wet gangrene because it allows primary wound closure a reduced chance of infection. To examine issue, 47 patients necrotizing foot were randomized prospectively receive either one-stage (definitive below- or above-knee delayed secondary skin in 3 5 days) (open ankle guillotine followed by definitive, closed amputation). Antibiotic coverage was standardized clindamycin and gentamicin used all patients. Preoperative blood cultures intraoperative obtained, as well from deep muscle lymphatic area along saphenous vein determine presence bacteria at level initial amputation. Twenty-four (11 diabetic 13 nondiabetic) procedure. Twenty-three (14 nine Five 24 group (21%) had positive vs 10 23 (43%). Two (8%) 7 (30%). complications attributable none (p = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)