下し切断の断端管理法の適応

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  • 佐鹿 博信
    横浜市立大学医学部病院リハビリテーション科
  • 大川 嗣雄
    横浜市立大学医学部病院リハビリテーション科
  • 伊藤 利之
    横浜市リハビリテーションセンター建設準備室

書誌事項

タイトル別名
  • Indications for post-operative stump managements of amputation.

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One-hundred and five patients of lower extremity amputee (mean age, 45 years old), who were operated in our hospital and exercised by rehabilitation team from 1968 to 1982, were examined retrospectively. And the indication of post-operative stump managements were discussed. Causes of amputation were disvascular condition of lower limb (41 limbs), malignant tumor (44 limbs), trauma (11 limbs) and others. Level of amputation were 7 limbs of hip disarticulations, 49 limbs of above knee amputation, 43 limbs of below knee amputation and others. Post-operative stump managements which we practiced were 10 limbs of controlled environmental treatment (CET), 45 limbs of immediate post-operative prosthetic fitting (IPPF), 7 limbs of rigid dressing, 33 limbs of soft dressing and others.<br>Main factors for choice of post-operative stump managements were pre-operative risks such as general conditions, cardio-respiratory diseases, mental functions, advanced age and others. Practically, there were so many patients to whom we had no choice but to do the soft dressing. In such cases, primary wound healing were poor. Other factors affecting choice of post-operative stump managements were 1) technical level of rehabilitation team, 2) cooperation of rehabilitation team and surgeons, 3) pre-operative evaluations about functional prognosis and needs of patients, 4) conditions of patients during operation.

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