Amputation Late

The tactics of late amputation is to waive the mandatory urgency of amputation after acute tissue necrosis of the gangrenous stage or even after gangrene, but later than 3 days from the moment of its occurrence. Therapeutic tactics are selected taking into account a large number of factors (classification of severity, age of the patient, presence of previous diseases of organs and systems, etc.).

Amputation is an option for surgically removing limbs that could potentially become a source of infection or recurrence of gangrene. The operation is performed by doctors in specialized medical institutions.

The main indications for late amputation are as follows: - Acute gangrene (hemorrhage into the swollen area) - if the pathological process is not eliminated by conservative methods within several days, and the patient’s condition sharply worsens, the issue of removing dead tissue is decided. History of recurrent gangrene of both lower extremities; - Traumatic injuries to the deep layers of the limb - thanks to surgical intervention, it is possible to avoid amputation surgery for traumatic syndrome. For example, a fracture or crush of the femur or tibia (so-called “immersion type fractures”) requires immediate amputation; - Potential circulatory failure with subsequent acute vascular necrosis;

The main goal of late amputation is to eliminate the purulent-necrotic focus and minimize the loss of limb tissue. Surgical intervention is carried out in accordance with the available diagnostic data and is determined by the doctor based on an assessment of the prevalence and degree of progression of gangrene (swelling of the skin over the affected area, swelling, severe redness, impaired movement, etc.). Depending on the current clinical picture, the procedure can be performed open, closed or using an endoscope. In addition, to eliminate possible infectious lesions of soft tissues, special antiseptic solutions, antibiotics with a bactericidal effect and proteolytic enzymes are used. After all stages of eliminating the consequences of gangrene, the surgeon carries out the process of osteosynthesis (joining bone fragments)