Nutrition as a prognostic indicator in amputations

Improved wound healing in transtibial amputees receiving supplementary nutrition

“…The only previous study with an extensive nutritional assessment among amputees found that 72% of patients were malnourished [22], similar to our study. Pedersen reported that malnourished amputees had a higher frequency of impaired healing and an increased risk of postoperative cardiopulmonary or septic complications [22].…”

“…Normal values of serum albumin and of the total lymphocyte count indicate a well nourished patient and predict a successful outcome after Syme's amputation [9], and in a study of 41 major lower limb amputations patients with a normal serum albumin and lymphocyte count had a decreased risk of healing complications [17]. The only previous study with an extensive nutritional assessment among amputees found that 72% of patients were malnourished [22], similar to our study. Pedersen reported that malnourished amputees had a higher frequency of impaired healing and an increased risk of postoperative cardiopulmonary or septic complications [22].…”

“…There is interest in the occurrence and effects of malnutrition in hospital patients [6,27], and it is common in those with osteoporotic hip fractures [8,16,20] and major amputees [9,17,22]. Malnourished patients have a greater risk of delayed healing, decubitus, infection, congestive heart failure, progressive weakness, apathy and death [11,15,16,22,28].…”

Energy Expenditure in Acute Posttraumatic Amputation

“…Individuals with traumatic amputation(s) experience an acute period of hypermetabolism, catabolism, altered immune and hormonal responses followed by a recovery period that may involve years of rehabilitation. Nutrition, particularly adequate caloric intake, is a critical component affecting recovery to include: wound healing, release from the hospital and return to optimized physical function 6 , 7 . It is therefore important that healthcare providers accurately estimate energy needs and aim to meet these needs through volitional oral intake or when appropriate, nutrition support.…”

Deficiencies in nutritional intake in patients admitted with diabetes‐related foot complications

“…It is known that adequate nutrition (protein, energy and specific vitamins and minerals) is important for the successful healing of pressure ulcers, amputation sites, skin grafts, lacerations and burns 6–8 . There are also data indicating that individuals with poor diets, those with chronic diseases, the elderly (especially those hospitalised), and individuals undergoing major amputations frequently have nutritional deficiencies 9–12 . In fact, studies have reported that 25–45% of hospitalised patients and 50% of general surgical patients have significant evidence of protein malnutrition 13–16 .…”