Nutritional status and wound healing in lower extremity amputations.

This prospective study examines the importance of nutritional status in 41 consecutive patients with lower extremity amputations proximal to the Symes level. The nutritional status of the patients was assessed by evaluating serum albumin levels and total lymphocyte counts, proven indices of nutritional status. Fifteen of 16 patients with normal nutritional parameters healed their amputations uneventfully, whereas 11 of 25 malnourished patients suffered either local or systemic postoperative complications. The difference in the complication rate between the nourished and malnourished groups is statistically significant (p less than 0.05). Malnutrition adversely affects the prognosis for healing lower extremity amputations, but it seems to be less detrimental to wound healing in the more proximal amputations, where blood flow is superior. Based on these findings, it is recommended that patients being admitted for lower extremity amputation should be screened at the time of admission, and those with laboratory parameters indicative of malnutrition should have elective surgery postponed until their malnourished state is corrected. Patients requiring urgent surgical treatment should probably receive supplemental nourishment in the perioperative period.