Year 2020, Volume 59 , Issue 4, Pages 251 - 257 2020-12-30

Indications, complications, and revisions of amputations in Turkey
Türkiye’de ampütasyonların endikasyonları, komplikasyonları ve revizyonları

Ömer ERŞEN [1] , Nisa Selin KILINÇ [2] , Ahmet Burak BİLEKLİ [3] , Çağrı NEYİŞCİ [4] , Doğan BEK [5]


Aim: The objective of this study is to determine the incidence of indications for amputations, major amputation related complications and revision numbers in Level I trauma center; which consists burn care unit, hyperbaric oxygen unit and hand surgery department in Turkey. Materials and Methods: Amputation procedures were retrospectively reviewed and evaluated according to the amputation levels, etiology, and demographic data. Major complications that require surgical intervention, type of surgical intervention for these complications and interval between index surgery and first complication related surgery were recorded. Re-amputations were evaluated according to interval between index and revision surgery, revision indication, and revised level. Results: A total of 558 amputations were performed for 476 patients (367 male, 109 female) in five-year period. The most common indication of amputation was diabetic complications, 250 amputations for 215 diabetic patients (44.8%) were performed. Peripheral arterial disease and trauma were the second and third common indications. The most common indication for upper extremity amputation was trauma. The most common amputation levels were hand amputations in the upper extremity, and below-knee amputation in the lower extremity. Fifty-seven of the surgical procedures were re-amputations and the interval between index surgery and revision amputation was 5.0±15.8 months. The most common indication for revision amputation was diabetic complications. Complications that required surgical intervention were infection in 46 patients, local soft tissue necrosis in 28 patients, and wound dehiscence in 2 patients. Conclusions: This is the first study investigating amputation etiology from high capacity hospital in capital city of Turkey that can demonstrate the whole country. The most common indications in this study were diabetic foot, PAD, and trauma as it is in developed countries. The results of this study can be the first step of multicenter epidemiological studies about amputations.
Amaç: Bu çalışmanın amacı, Türkiye’deki ampütasyon endikasyonlarının insidansını, ampütasyon sebepli majör komplikasyonları ve revizyon sayılarını yanık merkezi, hiperbarik oksijen ünitesi, el cerrahisi kliniği olan birinci seviye travma merkezinde belirlemektir. Gereç ve Yöntemler: Ampütasyonlar geriye dönük olarak incelendi ve amputasyon seviyeleri, etiyoloji ve demografik verilere göre değerlendirildi. Cerrahi gerektiren komplikasyonlar,bu cerrahilerin çeşitleri, revizyon cerrahisinin zamanı ve ilk cerrahi kaynaklı komplikasyonlar kaydedildi. Yeniden ampütasyonlar revizyon cerrahisi zamanına, revizyon endikasyonuna ve revize edilen seviyeye göre değerlendirildi. Bulgular: Beş yıllık dönemde 476 hastaya (367 erkek, 109 kadın) toplam 558 amputasyon yapıldı. En sık amputasyon endikasyonu diyabetik komplikasyonlardı, 215 diyabetik hastaya (%44,8) 250 amputasyon uygulandı. Periferik arter hastalığı ve travma ikinci ve üçüncü sık endikasyonlardı. Üst ekstremite amputasyonu için en yaygın endikasyon travmaydı. En sık görülen amputasyon seviyeleri üst ekstremitede yapılan el amputasyonları ve alt ekstremitede diz altı ampütasyon olarak bulundu. Cerrahi işlemlerin 57'si yeniden ampütasyondu ve ilk cerrahi ile revizyon amputasyonu arasındaki süre 5,0 ± 15,8 aydı. Revizyon ampütasyonunun en sık endikasyonu diyabetik komplikasyonlardı. Komplikasyonlar 46 hastada enfeksiyon, 28 hastada lokal yumuşak doku nekrozu ve 2 hastada yara ayrılmasıydı. Sonuç: Bu çalışma, Türkiye'nin başkentinde bulunan yüksek kapasiteli ve tüm ülkeyi temsil edebilecek bir hastanede ampütasyon etiyolojisini araştıran ilk çalışmadır. Bu çalışmada en sık endikasyonlar, gelişmiş ülkelerde olduğu gibi diyabetik ayak, PAH ve travmadır. Bu çalışmanın sonuçları, ampütasyonlarla ilgili çok merkezli epidemiyolojik çalışmaların ilk adımı olabilir.
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Primary Language en
Subjects Health Care Sciences and Services
Journal Section Research Articles
Authors

Orcid: 0000-0001-7351-6305
Author: Ömer ERŞEN (Primary Author)
Institution: Department of Orthopedics and Traumatology, Gulhane Education and Research Hospital, Health Sciences University
Country: Turkey


Orcid: 0000-0001-6705-8977
Author: Nisa Selin KILINÇ
Institution: Department of Orthopedics and Traumatology, Gulhane Education and Research Hospital, Health Sciences University
Country: Turkey


Orcid: 0000-0002-6294-4838
Author: Ahmet Burak BİLEKLİ
Institution: Department of Orthopedics and Traumatology, Gulhane Education and Research Hospital, Health Sciences University
Country: Turkey


Orcid: 0000-0001-8481-7808
Author: Çağrı NEYİŞCİ
Institution: Department of Orthopedics and Traumatology, Gulhane Education and Research Hospital, Health Sciences University
Country: Turkey


Orcid: 0000-0003-2156-9768
Author: Doğan BEK
Institution: Department of Orthopedics and Traumatology, Gulhane Education and Research Hospital, Health Sciences University
Country: Turkey


Dates

Application Date : January 23, 2020
Acceptance Date : June 8, 2020
Publication Date : December 30, 2020

Bibtex @research article { etd833737, journal = {Ege Tıp Dergisi}, issn = {1016-9113}, eissn = {2147-6500}, address = {}, publisher = {Ege University}, year = {2020}, volume = {59}, pages = {251 - 257}, doi = {10.19161/etd.833737}, title = {Indications, complications, and revisions of amputations in Turkey}, key = {cite}, author = {Erşen, Ömer and Kılınç, Nisa Selin and Bilekli, Ahmet Burak and Neyişci, Çağrı and Bek, Doğan} }
APA Erşen, Ö , Kılınç, N , Bilekli, A , Neyişci, Ç , Bek, D . (2020). Indications, complications, and revisions of amputations in Turkey . Ege Tıp Dergisi , 59 (4) , 251-257 . DOI: 10.19161/etd.833737
MLA Erşen, Ö , Kılınç, N , Bilekli, A , Neyişci, Ç , Bek, D . "Indications, complications, and revisions of amputations in Turkey" . Ege Tıp Dergisi 59 (2020 ): 251-257 <http://egetipdergisi.com.tr/en/pub/issue/58053/833737>
Chicago Erşen, Ö , Kılınç, N , Bilekli, A , Neyişci, Ç , Bek, D . "Indications, complications, and revisions of amputations in Turkey". Ege Tıp Dergisi 59 (2020 ): 251-257
RIS TY - JOUR T1 - Indications, complications, and revisions of amputations in Turkey AU - Ömer Erşen , Nisa Selin Kılınç , Ahmet Burak Bilekli , Çağrı Neyişci , Doğan Bek Y1 - 2020 PY - 2020 N1 - doi: 10.19161/etd.833737 DO - 10.19161/etd.833737 T2 - Ege Tıp Dergisi JF - Journal JO - JOR SP - 251 EP - 257 VL - 59 IS - 4 SN - 1016-9113-2147-6500 M3 - doi: 10.19161/etd.833737 UR - https://doi.org/10.19161/etd.833737 Y2 - 2020 ER -
EndNote %0 Ege Tıp Dergisi Indications, complications, and revisions of amputations in Turkey %A Ömer Erşen , Nisa Selin Kılınç , Ahmet Burak Bilekli , Çağrı Neyişci , Doğan Bek %T Indications, complications, and revisions of amputations in Turkey %D 2020 %J Ege Tıp Dergisi %P 1016-9113-2147-6500 %V 59 %N 4 %R doi: 10.19161/etd.833737 %U 10.19161/etd.833737
ISNAD Erşen, Ömer , Kılınç, Nisa Selin , Bilekli, Ahmet Burak , Neyişci, Çağrı , Bek, Doğan . "Indications, complications, and revisions of amputations in Turkey". Ege Tıp Dergisi 59 / 4 (December 2020): 251-257 . https://doi.org/10.19161/etd.833737
AMA Erşen Ö , Kılınç N , Bilekli A , Neyişci Ç , Bek D . Indications, complications, and revisions of amputations in Turkey. ETD. 2020; 59(4): 251-257.
Vancouver Erşen Ö , Kılınç N , Bilekli A , Neyişci Ç , Bek D . Indications, complications, and revisions of amputations in Turkey. Ege Tıp Dergisi. 2020; 59(4): 251-257.
IEEE Ö. Erşen , N. Kılınç , A. Bilekli , Ç. Neyişci and D. Bek , "Indications, complications, and revisions of amputations in Turkey", Ege Tıp Dergisi, vol. 59, no. 4, pp. 251-257, Dec. 2021, doi:10.19161/etd.833737

Authors of the Article
Ömer ERŞEN [1]
Nisa Selin KILINÇ [2]
Ahmet Burak BİLEKLİ [3]
Çağrı NEYİŞCİ [4]
Doğan BEK [5]