02568nas a2200301   4500000000100000008004100001653001300042653001900055653001400074653001200088653001000100653001300110653001500123100001200138700001200150700001500162700001200177700001600189700001300205700001200218700001300230245008700243856008900330300001100419490000600430520181600436022001402252       2015                            d10aRevision10aRehabilitation10aMorbidity10aleprosy10aIndia10aHospital10aAmputation1 aKumar D1 aSingh S1 aShantanu K1 aGoyal R1 aKushwaha NS1 aGupta AK1 aSharma 1 aSharma V00aNeed of revision of lower limb amputations in a north Indian tertiary care centre.  uhttp://jcdr.net/articles/PDF/6886/16385_CE(Ra1)_F(GH)_PF1(BMAK)_PFA(AK)_PF2(PAG).pdf  aRC01-30 v93 a<p><strong>INRTODUCTION: </strong>Amputation of the extremity is a big challenge to mankind. Revision rate of primary amputations stands high despite of maximum care at tertiary care centres. The purpose of this study was to establish cause for the revision, identify preventable cause and to assess outcome of revision amputation surgery.</p>

<p><strong>MATERIALS AND METHODS: </strong>We performed a retrospective study on lower limb revision amputations in Department of Physical Medicine and Rehabilitation and Department of Orthopaedic Surgery, King George Medical University between Jan 2012 to Jan 2015. All patients of any age group and gender admitted for revision amputation were included in the study population.</p>

<p><strong>RESULTS: </strong>A total of 32 patients who required revision amputation of lower limbs was included in the study, out of these 62.50 % were male and 37.50 % were female. Age of the patients ranged from 5 to 72 years with mean of 42 years. Most common level of initial amputation was below knee (56.25 %) followed by above knee amputation (31.25%). Most common indication for initial amputation was trauma (43.75%) followed by infection, vascular diseases, malignancy and leprosy. Poor stump formation was found to be most common indication for revision amputation (37.50%) followed by infection (25%), recurrent ulceration (18.75%), stitch abscess (6.25%), neuroma (6.25%), and necrosis (6.25%). All patients were treated successfully.</p>

<p><strong>CONCLUSION: </strong>Revision amputation increases morbidity. Poor stump formation at the time of initial amputation and infection are the most common indication for revision surgery. These are the preventable causes and every effort should be made to alleviate these as well as other preventable causes.</p>
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