ABSTRACT
Indications for and complications from amputation have changed over time. Early amputations in the history of mankind were mostly from trauma and associated with hemorrhage as the major complication, followed closely by infection. Complications from amputation can be divided into local issues such as wound necrosis and nonhealing, infection, bleeding and hematomas, contractures, as well as incisional and phantom pain and systemic complications such as mortality, cardiac or pulmonary issues, and venous thromboembolism. Conditions that interfere with wound healing, such as diabetes mellitus, malnutrition, or steroid treatment, are associated with a higher rate of wound infections, dehiscence, and repeated amputation. Diabetic control and nutritional status should be optimized as much as possible. Any infection should be grossly controlled prior to definitive amputation closure; debridements and prior open amputations may be required beforehand. A more distal amputation increases the rehabilitation potential at a cost of increased wound complications and nonhealing.
