Risk-Profiling and Early Wound Complications following Lower-Limb Amputation with Primary Stump Closure at Mayo Hospital, Lahore

Background: Surgical site infection (SSI) is known to complicate the outcome of below-knee amputation (BKA), negatively impacting recovery. To enhance outcomes, it is critical to identify risk factors of SSI. The aim of the study was to determine the frequency, contributing factors and independent predictors of SSI in patients who underwent BKA using primary stump closure. Methods: A prospective descriptive case series was done in the East Surgical Ward at the Mayo Hospital Lahore, a tertiary teaching hospital, over a period of six months (from May 2025 to November 2025). Consecutive enrollment of 77 patients aged 18-70 years with peripheral arterial disease and wet gangrene necessitating BKA was enrolled. All amputations were done through the long-posterior flap technique under spinal anesthesia. The duration of monitoring postoperative SSI was seven days. The data were examined through descriptive statistics, Chi-square, and logistic regression; a p-value below 0.05 was found to be significant. Results: SSI was present in 53 (68.8%) patients. The average age was 63 years old, and the majority of them were male (59, 76.6%). The frequent comorbidities were anemia (71, 92.2%), poor glycemic control (53, 68.8%), leukocytosis (45, 58.4%), renal failure (25, 32.5%), and peripheral arterial disease (40, 51.9%). The multivariate analysis presented a positive relationship between male gender and decreased risk of SSI (OR = 0.116, 95% CI: 0.014-0.973, p = 0.047). Conclusion: SSI occurs frequently in BKA using primary stump closure. Male gender lowers the risk of SSI, whereas other comorbidities and poor glycemic control do not have significant relationships.