gms | German Medical Science

Aim: To compare and evaluate the safety, efficacy and rehabilitation potential of equal flaps and unequal long posterior myocutaneous flap techniques in above knee amputation (AKA) in Diabetic patients.

Patients and Methods: 40 adult patients (18 males and 22 females) underwent (AKA) due to lower limb ischemia in Diabetic patients, and assigned to 2 groups; (20) cases in group (A) in whom AKA by equal fish-mouth flap was performed and (20) cases had AKA by long posterior myocutaneous flap; group (B). Duplex study was done with special concern on flow at deep femoral artery. Operative and post-operative data were collected and studied for comparison.

Results: Operative time was non-significantly longer in group (B) (1.25±0.23) hours (mean ± SD) versus (1.07±0.14) hours in group (A). One-year mortality rate was (7/20) (35%) in group (A) versus (10/20) (50%) in group (B), in-hospital mortality was (15%) for each group. Deep wound infection and stump revision rate was (1/17, 5.9%) in group (A) versus (3/17, 17.6%) in group (B). Prostheses were made for (3/13, 23.1%) still alive patients in group (A), versus only (1/10, 10%) still alive patient in group (B).

Conclusion: AKA using equal flaps in comparison to long posterior myocutaneous flap has relative advantages regarding shorter operative time and less infection and revision rates making patients more fit for rehabilitation.