LIMITED AMPUTATION FOR DISTAL LOWER EXTREMITY GANGRENE - A CASE SERIES

With the global epidemic of non-communicable diseases like diabetes, hypertension, dyslipidemia, obesity etc, the incidence of limb gangrene is also increasing. Management of limb gangrene includes identification of the cause and either revascularization or amputation. The level of amputation is usually guided by the level of gangrene, pregangrenous changes and the Doppler arterial study report. Being in a setup with limited vascular surgical access and increase demand for limb prosthesis and also considering the co morbidities and the needs of the patient, we opted for limited amputation followed by conservative management in five patients with distal gangrene. The limited amputation was done in patients with established monophasic flow in popliteal artery for whom below knee amputation would have been done otherwise. Only one patient required revision amputation below-knee for extending gangrene despite conservative management. The rest four patients responded well with limited amputation.