Although several objective tests have been described to aid in the selection of an amputation site which is likely to heal in a patient with arteriosclerosis obliterans of the lower extremity, most surgeons probably rely on clinical examination to make this decision.3,6 An error in judgment with regard to the adequacy of the circulation at the selected site may result in failure of the wound to heal. The resulting complications, the prolongation of confinement to bed, and the necessary reamputation increase morbidity and mortality. Many instances of failure could be avoided if amputation were performed only at a level sufficiently proximal to assure maximal vascularity. However, for the patient there are definite advantages in preserving as much of the limb as possible provided sound healing is obtained. Depending upon the level, these include ability to ambulate without a crutch or other prosthesis or to be fitted with a more
LEMPKE RE, KING RD, KAISER GC, JUDD D, NAHRWOLD D. Amputation for Arteriosclerosis Obliterans. Arch Surg. 1963;86(3):406–413. doi:10.1001/archsurg.1963.01310090056011
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