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:: Volume 8, Issue 2 (4-2019) ::
wjps 2019, 8(2): 146-162 Back to browse issues page
Four Extremity Amputation and Bionic Prosthesis Supply after Disseminated Intravascular Coagulation: A Follow-Up on Functionality and Quality of Life after Bionic Prosthesis Supply
Werner Dennis, Seyed Arash Alawi
Department of Plastic, Aesthetic, Hand and Reconstructive Surgery Hannover Medical School
Abstract:   (82 Views)
BACKGROUND
Disseminated intravascular coagulopathy (DIC) is a rare symptom complex that causes embolisms within the microvasculature and extensive necrosis of the skin and the acres. During surgical decision-making, preserving functionally important structures must be weighed against radical debridement. The aim was to analyze functional recovery and quality of life of patients sustaining amputations from disseminated intravascular coagulopathy and supplied with bionic prostheses.
METHODS
A monocentric, retrospective review of patients with disseminated intravascular coagulopathy after sepsis was conducted from 2016 to 2018. After initial reconstruction and intensive care treatment, patients were provided with bionic prosthetic devices. A follow-up survey measuring function and quality of life was performed.
RESULTS
Three patients (mean: 45 years; median: 50 years) were analyzed. The first necrectomy and amputation were performed, on average, after >4 weeks post-symptom onset. All patients required re-amputation, averaging two or one re-amputations in the right or left upper extremity, respectively, and one in ​​the lower extremities. On average, 12 operations for reconstruction of skin defects were required (x͂=8). On average, patients tolerated their prostheses for 5.67 h per day. Satisfaction metrics were either sufficient (SF-36, x̅=69) or moderate (TAPES-R, x̅=4.7). Physical skills were rated poor to fair (average TAPES-R=2.67). 
CONCLUSION
Supplying bionic prostheses after DIC yielded sufficient to moderate results. However, prothesis weight, signal transmission disorders, and repeated functional failures were suboptimal. For extensive stump scarring, implantable signal electrodes may improve signal transmission.
Keywords: Disseminated intravascular coagulopathy, Amputation, Reconstruction, Bionic, Myoelectric, Prosthesis, Rehabilitation
Full-Text [PDF 5554 kb]   (44 Downloads)    
Type of Study: Original Article | Subject: General
Received: 2019/04/28 | Accepted: 2019/06/18 | Published: 2019/06/18
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Dennis W, Alawi S A. Four Extremity Amputation and Bionic Prosthesis Supply after Disseminated Intravascular Coagulation: A Follow-Up on Functionality and Quality of Life after Bionic Prosthesis Supply. wjps. 2019; 8 (2) :146-162
URL: http://wjps.ir/article-1-503-en.html


Volume 8, Issue 2 (4-2019) Back to browse issues page
مجله جهانی جراحی پلاستیک World Journal of Plastic Surgery
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