Late amputation may not reduce complications
It is common in combat individuals with lower limb damage to attempt limb salvage in place of amputation where possible. However, dissatisfaction in this can lead to amputation later on and there is a strong indication that there is no reduction in physical complications or mental health issues and a high level of counselling should play a role in the early process.
Limb reconstruction showed links with complications such as soft tissue infection, joint pain, chronic regional pain syndrome, and nonunion. After late amputation soft tissue infection was still the most common complication, along heterotopic ossification, arthritis/joint pain, osteomyelitis and wound dehiscence.
Pain from the salvage limb and general dissatisfaction with it’s functionality are the most common reasons to resort to amputation.
Mental health issues are also common in combat trauma, however it was shown that the mental health diagnosis changed for the individuals after late amputation.
Patients frustrated with results of their salvage limb can often look to amputation as a miracle cure, however it is evident that this is not the case and reoperation is just as likely to be necessary.
Do you think the individual or the surgeon should have the most say in whether amputation is the better decision?
> From: Krueger et al., Injury (2015) (Epub ahead of print). All rights reserved to The Author(s). Click here for the Pubmed summary.