Early and long term outcomes following long posterior flap vs. Skew flap for below knee amputations.

Jesani, Lara, Gwilym, Brenig, Germain, Stephanie, Jesani, Hannah, Stimpson, Amy, Lennon, Alison, Massey, Ian, Twine, Christopher P. ORCID: https://orcid.org/0000-0003-0385-5760 and Bosanquet, David C. ORCID: https://orcid.org/0000-0003-2304-0489 2020. Early and long term outcomes following long posterior flap vs. Skew flap for below knee amputations. European Journal of Vascular and Endovascular Surgery 60 (2) , pp. 301-308. 10.1016/j.ejvs.2020.03.049

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Abstract

Objective To compare outcomes between long posterior flap (LPF) and skew flap (SF) amputation over a 13 year period. Methods This was a retrospective observational cohort study. Consecutive patients undergoing a LPF or SF below knee amputation (BKA) over a 13 year period at one hospital were identified. Both techniques were performed regularly, depending on tissue loss and surgeon preference. The primary outcome was surgical revision of any kind. Secondary outcomes included revision to above knee amputation (AKA), length of hospital stay (LOS), and mortality. A smaller cohort of patients who were alive and unilateral below knee amputees were contacted to ascertain prosthetic use and functional status. Results In total, 242 BKAs were performed in 212 patients (125 LPF and 117 SF; median follow up 25.8 months). Outcomes for the two groups were equivalent for surgical revision of any kind (27 LPF vs. 31 SF; p = .37), revision to an AKA (18 LPF vs. 14 SF; p = .58), LOS (29 days for LPF vs. 28 days for SF; p = .83), and median survival (23.9 months for LPF vs. 28.8 months for SF; p = .89). Multivariable analysis found amputation type had no effect on any outcome. Functional scores from a smaller cohort of 40 unilateral amputees who were contactable demonstrated improved outcomes with the LPF vs. the SF (p = .038). Conclusion Both techniques appear equivalent for rates of surgical residual limb failure. Functional outcomes may be better with the LPF.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Elsevier
ISSN:	1078-5884
Date of Acceptance:	30 March 2020
Last Modified:	26 Jun 2024 14:30
URI:	https://orca.cardiff.ac.uk/id/eprint/169997

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