Which specialist consultations are beneficial to patients prior to lower-extremity amputations?

Updated: Apr 29, 2021
  • Author: Janos P Ertl, MD; Chief Editor: Vinod K Panchbhavi, MD, FACS, FAOA, FABOS, FAAOS  more...
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A multidisciplinary approach to treatment should be taken. [7, 8] Patients undergoing amputation should be evaluated for cognitive and physical abilities. Consultation with a physical therapist, social worker, and possibly a psychiatrist should be obtained to determine the patient's ambulatory potential. Allowing the patient to talk with someone who has undergone an amputation can also prepare the patient for future expectations and provide answers to questions the patient may not have considered.

Patients with peripheral vascular disease (PVD) should have an evaluation by a vascular surgeon to determine the feasibility of vascular reconstruction. Consultation with an internal medicine specialist is also recommended for evaluation of the patient's general medical health and any cardiovascular disease, as well as control of diabetes mellitus, if appropriate. Mortality after lower-extremity amputations in diabetic patients can be high. [12, 29] In addition, many patients with PVD are malnourished and may have additional cardiac or cerebral ischemic disease. Infections that develop in these patients are often polymicrobial, and broad-spectrum antibiotics are recommended in conjunction with wide debridement.

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