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Kenneth E. McIntyre, Jr, MD; Susan A. Bailey, MD; James M. Malone, MD; Jerry Goldstone, MD

Arch Surg. 1984;119(4):450-453.

Abstract
• 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.

(Arch Surg 1984;119:450-453)

Author Affiliations
From the Surgical Service, Veterans Administration Medical Center, and the Department of Surgery, University of Arizona Health Sciences Center, Tucson.

Footnotes
Accepted for publication Nov 28, 1983.

Read before the Seventh Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Airlie, Va, May 28, 1983.

Reprint requests to Department of Surgery, Section of Vascular Surgery, Arizona Health Sciences Center, Tucson, AZ 85724 (Dr McIntyre).

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