Negative pressure wound therapy as postoperative dressing in below knee amputation stump closure of patients with chronic venous insufficiency.

UNLABELLED:  The role of negative pressure wound therapy (NPWT) in be- low knee amputation (BKA) stump closure is not well described. The purpose of this series was to analyze morbidity outcomes, particularly related to dehiscence, of BKAs treated with postoperative NPWT prior to definitive closure.

METHODS

Medical records were retrospectively re- viewed from six patients with large diameter legs due to chronic venous insufficiency of Charcot disease, who underwent a BKA and received postoperative NPWT between April 2006 and December 2008. NPWT was applied as a postsurgical dressing over closed fascia to help condi- tion the open stump for successful closure. Mean patient age was 56 years. The average hospital stay after BKA was 10 days (range, 6-15 days). Average duration of NPWT was 7 days (range, 4-9 days).

RESULTS

All patients survived to discharge. Complete reepithelializa- tion and healing of the stump averaged 84 days (range, 39-182 days) following initial placement of NPWT. Patients were casted for prosthe- sis in an average of 90 days (range, 42-187 days). The average follow- up time was 311 days (range, 210-440 days). None of the wounds dehisced or required repeat procedures during follow up. Complete wound closure was achieved in all cases, and no local or systemic complications were recorded for any of the patients.

CONCLUSION

This experience suggests that early, short-term application of NPWT may be a valuable adjunct in BKA stump closure. .