Abstract
We have encountered seven patients with severe crushed wounds of the lower limbs (eight lower limbs), and here we report the course of management.
The final outcome was amputation of five lower limbs and preservation of the other three. We compared the morphology of each wound. Regarding the condition of the wound at the time of injury, crush injury was observed in four limbs of the amputation group, and degloving injury in the fifth limb. In the limb-preservation group, incised wound was observed in one limb and crushed wound in two limbs.
Infection was the cause of amputation in all cases. We think that cause of infection can be attributed to the extent of wound contamination at the time of injury, and severity of crushing of the soft tissue especially the muscles. Moreover, selection of proper antibiotics should be considered till the causative bacteria can be proved. The systemic complications, patient's pain and functional prognosis of the lower limb should be taken in consideration to determine whether amputation is necessary or not.
