Srpski arhiv za celokupno lekarstvo 2016 Volume 144, Issue 9-10, Pages: 503-506
https://doi.org/10.2298/SARH1610503B
Full text ( 206 KB)
Cited by
Treatment of stump complications after above-knee amputation using negative-pressure wound therapy
Babić Srđan (Institute for Cardiovascular Disease “Dedinje”, Belgrade)
Tanasković Slobodan (Institute for Cardiovascular Disease “Dedinje”, Belgrade)
Lozuk Branko (Institute for Cardiovascular Disease “Dedinje”, Belgrade)
Samardžić Dražen (Institute for Cardiovascular Disease “Dedinje”, Belgrade)
Popov Petar (Institute for Cardiovascular Disease “Dedinje”, Belgrade + School of Medicine, Belgrade)
Gajin Predrag (Institute for Cardiovascular Disease “Dedinje”, Belgrade + School of Medicine, Belgrade)
Matić Predrag (Institute for Cardiovascular Disease “Dedinje”, Belgrade + School of Medicine, Belgrade)
Marić Vesna (Clinical Center of Serbia, Clinic of Eye Diseases, Belgrade)
Radak Đorđe (Institute for Cardiovascular Disease “Dedinje”, Belgrade + School of Medicine, Belgrade + Serbian Academy of Sciences and Arts, Belgrade)
Introduction. The stump wound complications after above-knee amputation lead
to other problems, such as prolonged rehabilitation, delayed prosthetic
restoration, the increase in total treatment cost and high mortality rates.
Objective. To evaluate the safety and outcomes of negative-pressure wound
therapy (NPWT) using Vacuum-Assisted Closure (VACR) therapy in patients with
stump complication after above-knee amputation (AKA). Methods. From January
2011 to July 2014, AKA was performed in 137 patients at the University
Cardiovascular Clinic. Nineteen (12.4%) of these patients (mean age 69.3 Ѓ}
9.2 years) were treated with NPWT. The following variables were recorded:
wound healing and hospitalization time, rate of NPWT treatment failure, and
mortality. Results. AKA was performed in 17 (89.5%) patients after the
vascular or endovascular procedures had been exhausted, while urgent AKA was
performed in two (10.5%) patients due to uncontrolled infection. The time
before NPWT application was 3.1 Ѓ} 1.9 days and the duration of the NPWT use
ranged from 15 to 54 days (mean 27.95 Ѓ} 12.1 days). During NPWT treatment,
operative debridement was performed in 12 patients. All the patients were
kept on culture-directed intravenous antibiotics. The average hospital length
of stay was 34.7 days (range 21-77 days). There were four (20.9%) failures
during the treatment which required secondary amputation. During the
treatment, one (5.3%) patient died due to multi-organ failure after 27 days.
Conclusions. The use of NPWT therapy in the treatment of AKA stump
complication is a safe and effective procedure associated with low risk and
positive outcome in terms of wound healing time and further complications.
Keywords: above-knee amputation, wound complication, negative-pressure wound therapy (NPWT)