USE OF SKIN GRAFTS IN LOWER EXTREMITY AMPUTATIONS: A VIABLE OPTION Ingrid Parry, MS, PT
Ingrid Parry, MS, PT; Nelson-Mooney, RN; Joel Lerman, MD; David Greenhalgh, MD; Tina Palmieri, MD
An objective of lower limb amputation is optimization of residual limb length to maximize a patient's potential function in a prosthesis. Recent studies have reported positive functional outcomes for amputee patients with skin grafts on the residual limb; however, this population had not been compared to amputees without skin grafts.
In our series, demographics, outcomes, and complications were compared for juvenile and adolescent amputees with skin grafts vs. similarly aged amputees without skin grafts. Records for 44 patients from 1997-2005 who underwent lower extremity amputation were reviewed and separated into two groups: those with skin grafts on their residual limbs and those without skin grafts.
Of the patients, 36% had skin grafts and 64% no skin grafts. There was no difference in the rate of stump revision or mean time of prosthetic disuse. Rate of patients eventually achieving independent gait was similar (83% of the skin graft group vs. 89% of the non grafted group). Patients in the skin grafted group were less likely to be fit with a prosthesis (75% vs. 96%).
Juvenile and adolescent patients with skin grafts on their amputated limb, when fit with a prosthesis, had similar complication rates and functional outcomes compared with non skin grafted patients. Stumps healed using skin grafts can withstand shear due to prosthetic use, and therefore skin grafting does appear a reasonable option to preserve stump length in young patients.
Shriners Hospitals for Children- Northern California, Sacramento, California