Year: 2024
Type: article
Study design: Observational Study
Abstract: Aim For certain complex orthoplastic patients, a below knee amputation (BKA) is the best form of reconstruction. An audit was carried out to assess whether orthoplastic patients undergoing BKAs at a major trauma centre in London were being managed according to best practice guidance set out by NICE and the Vascular Society. Method A retrospective review was carried out to analyse all BKAs that were performed on orthoplastic patients at the Royal London Hospital between 2020-2022. Patients were found by manually searching through the plastic surgery departmental inpatient database, and their electronic medical notes were reviewed for information specifically related to the recommendations set out by NICE guidelines for complex fractures and the Vascular Society’s guidance for major amputations. Results 19 cases were identified. The average age of patients was 45.8 years. 11 amputations were emergencies, 8 were planned. The average time to surgery once a decision was made to amputate was 1.75 days. Compliance was 100% with having an MDT discussion pre-operatively, recording the decision to amputate in the patient’s notes, and making a formal referral to the amputee rehabilitation team for prosthetics. Areas of lower compliance included giving written counselling to families, naming a discharge co-ordinator pre-operatively, and review by the pain team within 24 hours post operation. Conclusions This audit has identified specific areas for improvement and will help to develop a written pathway for lower limb amputations in the trust, ensuring that patients undergoing BKAs receive the best care possible.
Source: British journal of surgery
Authors: K Chan, P Singh, A Iliadis, G Pafitanis
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4402014983