Скачать с ютуб Transtibial- Below Knee- Amputation for the Ischemic Limbs в хорошем качестве

Transtibial- Below Knee- Amputation for the Ischemic Limbs

The frequent comorbidities in patients with ischemic limbs demand precautionary measures and interaction with a vascular surgical team. Because the skin's blood supply is much better on the posterior and medial aspects of the leg than on the anterior or anterolateral sides, transtibial amputation techniques for the ischemic limb are characterized by skin flaps that favor the posterior and medial side of the leg. The long posterior flap technique popularized by Burgess is most commonly used, but medial and lateral flaps of equal length as described by Persson, skew flaps, and long medial flaps are being used. All techniques stress the need for preserving intact the vascular connections between skin and muscle by avoiding dissection along tissue planes and by constructing myocutaneous flaps. Also, amputations performed in ischemic limbs are customarily at a higher level (e.g., 10 to 12.5 cm distal to the joint line) than are amputations in nonischemic limbs. Tension myodesis and the osteomyoplasty procedure of Ertl, which may be of value in young, vigorous patients, are contraindicated in patients with ischemic limbs because the procedures tend to compromise an already precarious blood supply. #belowkneeamputation, #Burgesstechnique,#ischemiclimbs,#amputation, #ischemiclimbamputation,#atheroscleroticarterydisaease,#mangledextremity,#gangrene,#diabeticfoot,#transtibialamputation