A standardised trans-tibial amputation method following chronic occlusive arterial disease.

The histo- and biochemical parameters of leg muscles from patients with chronic occlusive arterial disease were examined. The outcome of these tests indicated that it is not possible visually to determine the amputation level accurately at the time of surgery. These test results therefore encouraged the authors to develop a standardised surgical procedure for trans-tibial amputations. With this standardised technique specific musculature is resected to assure that no pathological tissues remain. This surgical prophylaxis is meant to prevent the development of gas gangrene and thus to obtain primary healing. Eighty-six trans-tibial amputations were performed and in 93% of these the knee joint was preserved.