Timing of Amputations in Peripheral Vascular Disease

Abstract

The medical charts of 29 patients who underwent 31 episodes of foot ampu tations, toe or transmetatarsal, preceded by arterial bypass procedures for limb salvage in the presence of ischemic gangrene, were reviewed retrospectively. Seventy-one percent of the attempts were successful and the success rate ap peared to be affected by the timing of the procedures, with 88% limb salvage for those undergoing bypass first versus 50% for those undergoing amputation first or at the same time as bypass. This significance was duplicated in reviewing both diabetic patients and those with wet gangrene. The authors recommend that in most cases, patients with reconstructable vascular lesions and concomi tant localized gangrene should have bypass procedures preformed before ampu tations.