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Journal of Long-Term Effects of Medical Implants
SJR: 0.145 SNIP: 0.491 CiteScore™: 0.89

ISSN Imprimir: 1050-6934
ISSN En Línea: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2020033148
pages 205-207

Lower Limb Stump Fistula Treated with Laser Ablation. A Possible Alternative Minimal Invasive Technique

Dimitrios Filippou
Department of Anatomy and Surgical Anatomy, Medical School, National and Kapodestrian University of Athens · Athens, GRC
Stavros Angelis
2nd Orthopaedic Department, General Children's Hospital, Athens, Greece; Orthopaedic and Trauma Department, Hellenic Red Cross Hospital, Athens, Greece
Alexandros P. Apostolopoulos
Trauma and Orthopaedic Department, "Korgialenio-Benakio" Hellenic Red Cross Hospital, Athens, Greece; Trauma and Orthopaedic Department, Ealing Hospital, North West University Healthcare NHS Trust, London, United Kingdom
Georgios Vynichakis
2nd Orthopaedic Department, General Children's Hospital, Athens, Greece; Panagiotis and Agliaia Kyriakou Childrens Hospital, Athens, Greece
Marios Salmas
Anatomy and Surgery Anatomy Laboratory, Anatomy Department, Medical School of National and Kapodistrian University of Athens, Athens, Greece
Konstantinos Vlasis
Anatomy Department, Medical School, National & Kapodistrian University of Athens, Athens, Greece

SINOPSIS

Stump-wound infections are a common cause of complications after amputation. Wound infections, usually after major lower-limb amputation, vascular disease, or trauma, may lead to fistula formation. The main therapeutic options for these infections include antibiotic administration alone or antibiotic treatment in combination with surgery. Fistula management may require multiple surgical interventions that increase morbidity and cost and require long-term treatment prohibiting early mobilization of patients. We present a novel technique based on diode laser energy to destroy the fistula tract. This method has been applied on two patients with excellent results. It is easy to perform, safe, repetitive, well tolerated, and it can be performed under local anesthesia. This technique seems to offer excellent results.

REFERENCIAS

  1. Dutronc H, Gobet A, Dauchy FA, Klotz R, Cazanave C, Garcia G, Lafarie-Castet S, Fabre T, Dupon M. Stump infections after major lower limb amputation: a 10-year retrospective study. Med Mal Infect. 2013 Dec;43(11-4. 12):456-60. doi: 10.1016/j.medmal.2013.09.003. .

  2. Dunkel N, Belaieff W, Assal M, Corni V, Karaca S, Lacraz A, Ufkay I. Wound dehiscence and stump infection after lower limb amputation: risk factors and association with antibiotic use. J Orthop Sci. 2012 Sep;17(5):588-94. doi: 10.1007/s00776-012-0245-5. .

  3. Filippou DK. Concerns: M. Dessily, F. Charara, S. Ralea & J.-L. Alle. Pilonidal sinus destruction with a radial laser probe: technique and first Belgian experience. Acta Chir Belg. 2017;117(3): 164-68. Acta Chir Belg. 2018 Feb;118(1):72. doi: 10.1080/00015458.2017.1337340. .

  4. Bamberger DM. Osteomyelitis. A common sense approach to antibiotic and surgical treatment. Postgrad Med. 1993 Oct;94(5):177-82. .

  5. Mcintosh J, Earnshaw JJ. Antibiotic prophylaxis for the prevention of infection after major limb amputation. Eur J Vasc Endovasc Surg. 2009 Jun;37(6): 696-703. doi: 10.1016/j.ejvs.2009.01.013. .


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