Prognosis of the development of purulent-necrotic complications in stump of the hip

Abstract

Purpose of the study : to develop of method for prediction of development of purulent-necrotic complications in amputation stump of the hip. Material and methods. 90 disease histories of patients of both sexes were analyzed, aged 40–91 years old (mean age 65 (40; 91)), admitted to the hospital with a diagnosis of obliterating atherosclerosis of the vessels of the lower extremities, critical ischemia or gangrene of the foot. Patients were divided into two clinical groups: 1st group - 69 (76.7%) patients with a favorable course of the postoperative period; and 2nd group – 21 patients (23.3%) with a complicated postoperative period of infection of the thigh stump wound. Results . The original method developed includes the determination of the following risk factors: the systemic nature of atherosclerotic vascular damage; amputation at the level of the upper third of the hip; emergency surgery; hematoma in the early postoperative period; prothrombin time; INR; a quick prothrombin test: when receiving the sum of points 16 and more, a high risk of development is predicted, with the sum of points from 13 to 15 – moderate risk; and with a score of less than 12 – low risk of developing purulent-necrotic complications in amputation stump of the hip. Conclusion . Proposed method allows to objectively and quickly determine development of purulent-necrotic complications in amputation stump of hip, which further allows to correct starting therapy and in cases of high risk of development of complications, to prescribe enhanced antibacterial and detoxification therapy.