Relation between rates of leg amputation and distal arterial reconstructive surgery

Abstract

A recent audit of vascular surgical practice in the Oxford region showed distinct variation between districts in the rate and level of leg amputations for occlusive arterial disease.1 There were also considerable differences between districts in the volume and nature of reconstructive arterial surgery. Arterial bypass grafting of the calf or foot, operations largely reserved for limb salvage, were undertaken in only two hospitals in the region. We carried out a six month prospective audit to study in greater detail the relation between distal reconstructive arterial surgery and leg amputation. The Oxford region has a total population of 2.5 million, with eight districts serving populations of 150 000 to 550 000. On the basis of the previous audit we divided districts into …