TY - JOUR PY - 1999// TI - Below-knee amputations as a result of land-mine injuries: comparison of primary closure versus delayed primary closure JO - Journal of trauma A1 - Ateşalp, A. Sabri A1 - Erler, Katrin A1 - Gür, E. A1 - Solakoglu, C. SP - 724 EP - 727 VL - 47 IS - 4 N2 - BACKGROUND: Antipersonnel land mines are designed to maim by mutilating the lower extremities, and these injuries are at higher risk for infection than injuries from other weapon systems. METHODS: The results of 474 unilateral traumatic below-knee amputations as a result of land-mine injuries were reviewed. If the delay in evacuation between the injury and arrival to the battle field hospital was less than 6 hours, 392 amputation stumps (group I) were closed primarily after meticulous debridement. Open amputation was performed after debridement in the remaining 82 amputation stumps (group II), because there was a suspicion of ineffective debridement, although they were evacuated in less than 6 hours or delay was more than 6 hours. RESULTS: Eleven patients in group I (2.8%) were reoperated because of wound sepsis of the stump. Wound sepsis was not encountered in group II. A total of 87.4% of stumps in group I and 81.2% of stumps in group II had healed without a problem. No gas gangrene or tetanus was encountered in any cases. CONCLUSION: Our results reveal that primary closure may be done in traumatic below-knee amputations caused by land-mine injuries with an acceptable infection rate, if the evacuation time is less than 6 hours, and if there is meticulous debridement.

Language: en

LA - en SN - 0022-5282 UR - http://dx.doi.org/ ID - ref1 ER -