| Theme |
Orthopedic Diseases Seen in Maintenance Dialysis Patients -- Surgical Indication and Non-indication |
| Title |
Limb amputation in dialysis patients |
| Author |
Eiji Hanaoka |
Department of Orthopaedic Surgery, Chiba Social Insurance Hospital |
| Author |
Noriyoshi Murotani |
Department of Hemodialysis, Chiba Social Insurance Hospital |
| [ Summary ] |
Critical limb ischemia results in considerable morbidity and mortality in dialysis patients. Favorable results have been reported concerning revascularization due to percutaneous transluminal angioplasty or transdermal angioplasty, making it possible to rescue the limb. However, when improvement of ischemia is not obtained, amputation must be performed. Even if the dialysis patient has only a small wound (stigma), care must be taken to confirm if infection is present. Since the general condition of gangrenous dialyzed patients is not good from the outset, it is necessary to recognize that these patients have a high risk of death. It needs to consult an orthopaedic surgeon whenever gangrenous tissue develops rapidly. As soon as the patient's foot appears to develop into a morbid state, consultation with a doctor who can be considered to be the gatekeeper should be taken to avoid amputation. |