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KMID : 1123420140080010024
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Journal of Korean Society for Prosthetics and Orthotics
2014 Volume.8 No. 1 p.24 ~ p.28
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Amputations in Elderly
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Kim Ji-Hyeung
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Abstract
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Amputation is one of the most ancient surgical procedures. The causes of amputation are diabetes, peripheral vascular disease, uncontrolled infection, tumor and trauma. When we perform lower extremity amputation, determination of the appropriate level is most important. If we perform a more distal level of amputation, we can expect increased function, however, if we perform a more proximal level of amputation, we can decrease the complication rate of amputation. Vascular intervention should be considered before amputation. It can decrease the extent of ischemia and is helpful to the wound healing after amputation. Before amputation, simple screening tests for nutritional status and immunocompetence should be performed. Malnourished or immunocompromised patients have markedly increased rates of perioperative complications. We can classify lower extremity amputation into minor amputation and major amputation. Minor amputation includes forefoot amputation, midfoot amputation and hindfoot amputation, and major amputation includes below knee amputation, knee disarticulation, above knee amputation and hip disarticulation. Postoperative care of amputation requires a multidisciplinary team approach. This team includes a physical medicine specialist, a physical therapiest, an occupational therapiest, a psychologist, and prosthetist.
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KEYWORD
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Amputation, Disarticulation, Major amputation, Minor amputation, Rigid dressing, Soft dressing
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