Perioperative management in amputations: Narrative review

Amputation is defined as the partial or total removal of upper or lower limbs and is a frequent procedure, with approximately 5,000 cases annually in the United Kingdom and 150,000 in the United States. In Colombia, the incidence is estimated to be between 200 and 300 amputations per 100,000 inhabitants, with 10% of the population reported as having a disability in 2010. The main causes of amputation include occlusive vascular diseases, diabetes mellitus, neuropathy, and trauma, with elderly patients with comorbidities being the most affected. The incidence of amputations is directly related to peripheral arterial disease, neuropathy, and soft tissue damage, with diabetes mellitus present in 82% of cases in the United States. The level of amputation depends on the viability of the soft tissues to cover the bone, and patients show a high postoperative mortality rate within 30 days, along with complications such as respiratory infections, wound infections, limited mobility, and postoperative pain. This narrative review gathered updated information from 25 articles obtained from databases such as PUBMED and ScienceDirect, highlighting the importance of an interdisciplinary approach to improve postoperative outcomes in patients with lower limb amputation. This allows for the development of pertinent evidence-based recommendations to achieve the best possible outcomes when managing patients requiring amputation as part of their treatment.