Complications - Right-sided through-the-knee amputation in Fontaine stage IV peripheral arterial disease – Vascular Surgery

• Too short soft tissue flaps may constrict sutures and result in necrosis and a stump unable to bear weight –> transcondylar amputation with patellar resection or distal transfemoral amputation

Secondary bleeding /hematoma: Breeding ground for infection, wound dehiscence, “internal decubitus ulcer” due to hematoma -> prompt surgical revision

Dehiscent and necrotic wound Skin closures under tension or subsequent tension/pressure -> prompt surgical revision and shortening of the nerve stumps and bone

Infection: Surgical revision / debridement, possibly repeat resection AST-based antibiotics

Phantom / stump and neuropathic pain: High-dose analgesics/interdisciplinary pain management; instigate effective pain management already preoperatively, epidural catheter