Early outcome of vascular lower limb amputations at a National Referral Hospital in Kenya

Author Information

K.O. Awori, MBChB, MMed (Surgery), Assistant Lecturer, Department of Human Anatomy, School of
Medicine, University of Nairobi and Consultant Surgeon, Division of Orthopaedics, Kenyatta National
Hospital, Nairobi, Kenya. J.E.O. Ating’a, MBChB, MMed (Surgery). M.Ch (Ortho), Associate Professor,
Department of Orthopaedic Surgery, School of Medicine, University of Nairobi and Consultant Surgeon,
Division of Orthopaedics, Kenyatta National Hospital, Nairobi, Kenya, P.O. Box 19676- 00202, Nairobi,
Kenya
Corresponding author: Dr. K.O. Awori, Department of Human Anatomy, School of Medicine, University of
Nairobi, P.O. Box 30197- 00100, Nairobi, Kenya, Email: karsto2005@yahoo.comE.A. Opondo, MBChB, MMed (Surg), General surgeon, North Kinangop Mission Hospital, Surgery Department and The Mater Hospital Nairobi, surgery department, N.J.M. Mwangombe, MBChb, MMed(surg), PhD (Lond), Associate Professor, Department of Surgery, University of Nairobi and Head Division of Neurosurgery

Corresponding author:

Dr. E.A. Opondo, P.O. Box 00202105, Nairobi, Email dropondo@yahoo.co.uk

Abstract

BACKGROUND: Majority of lower limb amputations performed in the African setting have been reported to be mainly due to trauma and neoplasms. These affect mainly young and therefore, fit individuals with lower risks of complications. Recent local studies show an increase in the incidence of cardiovascular diseases including peripheral vascular diseases. These are associated with higher rates of both systemic and amputation stump-related complications. There is however little published data in Africa on the outcomes of vascular lower limb amputations.

OBJECTIVE: To determine the early outcome of vascular lower limb amputations.

DESIGN: Descriptive prospective study, conducted between July 2003 and June 2004.

SETTING: The Kenyatta National Hospital, the largest referral and teaching hospital in Kenya.

SUBJECTS: All patients with gangrene of the lower limb due to occlusive peripheral vascular disease not caused by trauma or inappropriate limb splintage who were amputated at Kenyatta National Hospital during the study period were included.

OUTCOME MEASURES: These included the wound healing time, number of stump revisions, number of conversions to a higher amputation level, the thirty-day post-operative mortality and the hospitalization period.

CONCLUSION: While the findings of this study compare with other series, the prolonged hospital stay is of concern considering the younger average age of the patients.

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