Wound dehiscence and stump infection after lower limb amputation: risk factors and association with antibiotic use

J Orthop Sci. 2012 Sep;17(5):588-94. doi: 10.1007/s00776-012-0245-5. Epub 2012 Jun 6.

Abstract

Background: Optimal duration of antibiotic prophylaxis following major lower limb amputation in preventing adverse stump outcomes is controversial.

Objective: We assess the epidemiology and risk factors of wound dehiscence and stump infection after mid-thigh to transmetatarsal amputations with regard to antibiotic administration.

Methods: Our retrospective observational study at the Geneva University Hospital (January 1995-June 2010) includes a total of 289 amputations in 270 adult patients (199 males; median age 70 years).

Results: Wound dehiscence and/or stump infection occurred in 47 (16.3%) and 63 (21.8%) patients with a median delay of 24 and 14 days, respectively. No clinical variable was significantly associated with stump infection. Diabetes and older age (>80 years) were associated with dehiscence. Importantly, transcutaneous tissue oxygen tension (TcPO2) and duration of antibiotic administration showed no association with either outcome.

Conclusion: The duration of antibiotic administration before or after surgery does not change the epidemiology of stump complications.

MeSH terms

  • Aged
  • Amputation Stumps*
  • Amputation, Surgical / adverse effects*
  • Antibiotic Prophylaxis / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Dehiscence / epidemiology*
  • Surgical Wound Infection / epidemiology*
  • Time Factors