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  • 1
    Electronic Resource
    Electronic Resource
    Neurovascular lower extremity complications of the lithotomy position (1992)
    Springer
    Annals of vascular surgery 6 (1992), S. 357-361 
    Details
    ISSN: 1615-5947
    Keywords: Lithotomy position ; lower extremity complication ; pelvis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The lithotomy position is commonly used during the performance of a variety of abdominal and pelvic operations. Previous publications reporting complications with these operations have been largely anecdotal. We report our experience with eight patients over the past four years who have suffered serious lower extremity complications following operations in which the lithotomy position was used. The average time in the lithotomy position for our patients was 7.4 hours (range: 3.7–12 hours). The mean interval between the original operation and the secondary operation to treat the lower extremity complication was 18.9 hours (range: 2–51 hours). The average hospital length of stay for these patients, 38.4 days (range: 11–119 days), was often prolonged as a direct result of their limb complication. Serious lower extremity complications may result from operations in which the lithotomy position is used. To prevent such complications, strict attention should be paid to the positioning of the limbs in the operating room and the time in the lithotomy position should be minimized. Perioperative monitoring of the lower extremity circulation and compartment pressures are essential in these patients since early detection and treatment of these complications is the only way to prevent permanent limb injury.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02008793
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  • 2
    Electronic Resource
    Electronic Resource
    Natural history of claudicants with critical hemodynamic indices (1992)
    Springer
    Annals of vascular surgery 6 (1992), S. 31-33 
    Details
    ISSN: 1615-5947
    Keywords: Claudication ; hemodynamic indices ; peripheral vascular disease ; limb salvage ; amputation ; ischemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed the records of approximately 1,500 patients seen in the Vascular Laboratory of the Cincinnati Veterans Affairs Medical Center from 1980 to 1987 and identified 23 patients (25 limbs) who metall of the following criteria: 1) an ankle/brachial index less than or equal to 0.35; 2) an ankle or transmetatarsal pulse volume recording less than or equal to 3 mm in amplitude; and 3) no history of ischemic rest pain or gangrene. These patients were followed in the Vascular Laboratory for periods ranging from 11 to 127 months (mean 45.2 months). The study was terminated in March 1991 or when revascularization or amputation was required for limb-threatening symptoms or if the patient expired. Thirteen extremities (52%) showed no progression to limb-threatening symptoms. Claudication actually improved in three, remained unchanged in eight, and progressed in two. Twelve (48%) extremities developed limb-threatening conditions, with rest pain occurring in three, ischemic ulceration in six and gangrene in three. Eight of these limbs underwent revascularization and only one ultimately required major amputation. Another extremity presented with extensive gangrene and underwent a primary above-knee amputation. Three other patients did not undergo revascularization because of death in one and refusal in two others. Patients with intermittent claudication who have critical hemodynamic indices are at much greater risk for developing symptomatic limb-threatening ischemia. Close follow-up is mandatory since nearly half of these patients will eventually require operation for limb salvage. Patients who are unlikely to comply with a regular follow-up program may be considered for early revascularization to prevent complications of limb-threatening ischemia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02000664
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    Paper (German National Licenses)
    Fulltext
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