Amputation for gangrene because of occlusive arterial disease: Results in 312 amputations

Abstract

1. 1. Results and experiences with 312 amputations for gangrene caused by peripheral arterial disease are presented. 2. 2. The operative mortality for major amputations was reduced from 20 per cent in the 1936 to 1938 period to 7.6 per cent in the 1945 to 1948 period. During the same periods, the number of below-knee amputations increased from 6 to 32 per cent. 3. 3. Lumbar sympathectomy will often permit amputation at a lower level than would be possible otherwise. 4. 4. Femoral vein ligation below the profunda femoris at the time of major amputation will reduce the incidence of pulmonary embolism. 5. 5. Local refrigeration, in indicated patients will reduce toxic absorption from the gangrenous and inflamed part and allow time for adequate preoperative preparation. 6. 6. Amputation for ischemic gangrene need never be performed as an emergency.