Behandlungsverlauf nach Amputationen an der unteren Extremität

Course of treatment after amputations of the lower extremity

by Laura Bemmer née Mackerodt
Doctoral thesis
Date of Examination:2020-11-17
Date of issue:2020-11-03
Advisor:Prof. Dr. Stephan Sehmisch
Referee:Prof. Dr. Stephan Sehmisch
Referee:Prof. Dr. Siegmar Blumentritt
Persistent Address: http://dx.doi.org/10.53846/goediss-8288

 

 

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Abstract

English

This paper deals with the retrospective analysis of minor and major amputations performed at the Department of Trauma Surgery, Orthopaedics and Plastic Surgery at the University Hospital Göttingen in the period from 2011 to 2014. The aim of this analysis was to investigate the surgical complication rate and thus the course of treatment after a lower limb amputation. Furthermore, the dependence of surgical complications on age, amputation level, causes, comorbidities and medication intake was to be determined. Lifestyle, preoperative vascular surgical interventions and length of hospital stay also played a role in this context and were included in the evaluation of this study. The evaluation showed that 37 patients received a minor amputation and 72 patients a major amputation. The presence of diabetes mellitus and peripheral arterial disease were identified as the most important factors promoting the development of an impending sepsis. This was ultimately the most frequent indication for amputation. In the majority of patients a single amputation was sufficient to achieve a successful recovery. In 19% of the patients, re-amputation was performed due to complications, which were mainly promoted by comorbidities and could not be controlled with conservative treatment. A significant correlation between the intake of acteylsalicylic acid and the occurrence of postoperative surgical complications requiring debridement was found. Therefore acteylsalicylic acid cannot be attributed a protective effect with regard to surgical complications. To what extent vascular surgical interventions influence the surgical complication rate after amputation could not be conclusively clarified. The length of hospitalization in the presence of postoperative surgical complications increased significantly. The prevention of risk factors is an important aspect in avoiding surgical complications after amputation.
Keywords: minor amputation; major amputation; lower limb amputation; re-amputation; surgical complication rate; postoperative surgical complications; diabetes mellitus; peripheral arterial disease; vascular surgical intervention; hospitalization; acteylsalicylic acid
 
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