Community-wide feasibility of the Lower Extremity Amputation Protocol amongst vascular amputees

Matheny, Heather; Woo, Karen; Siada, Sammy; Qumsiyeh, Yazen; Aparicio, Carolina; Borashan, Christian; O’Banion, Leigh Ann

doi:10.1016/j.jvs.2023.06.001

Cited by 4 publications

(1 citation statement)

References 28 publications

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“…One particularly pertinent work was proposed by Matheny and colleagues in the form of the Lower Extremity Amputation Protocol (LEAP), a combination of pre, intra-and postoperative interventions, including preoperative assessment and counseling, the employment of multimodal and regional anesthesia unless contraindicated, and early fitting of limb protectors, physical and occupational therapy, and standardized prosthesis fitting. Early results suggest a lower incidence of PLP, shorter length of stay, and faster prosthetic use [103].…”

Section: Discussionmentioning

confidence: 99%

Chronic post amputation pain: pathophysiology and prevention options for a heterogenous phenomenon

Stone

Hollmann

Terwindt

et al. 2023

Current Opinion in Anaesthesiology

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Purpose of review Chronic postamputation pain (cPAP) remains a clinical challenge, and current understanding places a high emphasis on prevention strategies. Unfortunately, there is still no evidence-based regimen to reliably prevent chronic pain after amputation. Recent findings Risk factors for the development of phantom limb pain have been proposed. Analgesic preventive interventions are numerous and no silver bullet has been found. Novel techniques such as neuromodulation and cryoablation have been proposed. Surgical techniques focusing on reimplantation of the injured nerve might reduce the incidence of phantom limb pain after surgery. Summary Phantom limb pain is a multifactorial process involving profound functional and structural changes in the peripheral and central nervous system. These changes interact with individual medical, psychosocial and genetic patient risk factors. The patient collective of amputees is very heterogeneous. Available evidence suggests that efforts should focus on prevention of phantom limb pain, since treatment is notoriously difficult. Questions as yet unanswered include the evidence-base of specific analgesic interventions, their optimal “window of opportunity” where they may be most effective, and whether patient stratification according to biopsychosocial risk factors can help guide preventive therapy.

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Section: Discussionmentioning

confidence: 99%