MedicineOrthopaedic SurgerySurgeryAnesthesiaOrthopedicsProstheticsAmputationDressing SelectionProsthetic CareProsthetic FittingAbsorbent DressingsBelow-knee AmputationFunctional Capacity RecoveryFunctional Recovery AnalysisFunctional Recovery MetricsLower Limb IschemiaSoft DressingsStump Dressing Management
Results of 52 consecutive below-knee amputations for lower extremity ischemia were evaluated to determine whether use of immediate fit prostheses (IPOP) instead of soft stump dressings had any bearing postoperative hospitalization time, functional recovery, postoperative pain, morbidity, and mortality in amputees. Of 34 patients receiving IPOP, 21 per cent developed stump necrosis, 21 per cent had wound infection, 26 per cent required major reamputation, and 12 per cent died within 30 days of operation. Of 18 patients treated with soft stump dressings, 17 per cent developed necrosis, 33 per cent infection, 44 per cent required reamputation, and 11 per cent died postoperatively. None of these differences was statistically significant. Mean hospitalization time and average narcotic requirements for analgesia were also similar in both groups. Fifty-six per cent of patients with IPOP and 22 per cent of those with soft dressings ultimately ambulated with prostheses (P less than 0.05). Whether or not IPOP was used had little if any effect on the early evolution of vascular amputees in this series.