Risk factors for impaired wound healing and prolonged hospitalization in patients after amputation of the lower limb above the knee joint.

ntroduction: Lower limb amputation is a surgery performed as a last resort, when all other therapeutic options have been exhausted. The duration of treatment lasts from a few to several months and depends on the extent of amputation, the patient's overall health and the course of the stump healing process. MATERIALS AND METHODS: A retrospective analysis was performed using the database of the General and Vascular Surgery Ward of the Nikolay Pirogov Regional Specialist Hospital in Lódz. Patients who underwent lower limb amputation at the transfemoral level in 2017 were analyzed. 92 patients undergoing surgery were qualified for the study. Patients were divided into two groups: those with no healing complications and those with stump healing complications. Medical records of both groups were analyzed for risk factors for impaired healing. The obtained data were subjected to statistical analysis. RESULTS: Patients with impaired stump healing most often had minimal bleeding and higher ASA scores compared to patients without healing complications. No differences between the two groups were found for the remaining parameters. Patients with complications needed an average of 28 days to heal the wound and spent an average of 40 days in hospital, compared to 14 and 21 days, respectively, for patients without complications. The percentage of deaths in the group of patients with complications was also significantly higher (35%) than in the group of patients without complications (5%). CONCLUSIONS: Statistically significant factors increasing the risk of impaired stump healing include high ASA scale and minimal muscle bleeding during surgery. Patients who experienced this complication are at greater risk of prolonged hospitalization and death in the postoperative period. This study showed statistically significant risk factors for impaired stump healing following amputation and confirmed the negative impact of this complication on the length of hospitalization and risk of death.

[Mitral regurgitation in course of Bland-White-Garland syndrome in female patient after four uncomplicated physiological labours]. / Niedomykalnosc zastawki mitralnej w przebiegu zespolu Blanda-White'a-Garlanda u chorel po czterech niepowiklanych porodach fizjologicznych.

A 35-year-old female, mother of 4 children was admitted to the hospital for coronary angiography before scheduled surgical correction of severe mitral insufficiency. During angiography anomalous ostium of left main artery from pulmonary trunk was found. The patient underwent mitral ring correction, implantation of LIMA-LAD graft and ligation of left coronary artery during open heart surgery.

[Medico-legal problems of providing first aid]. / Prawno-medyczne problemy udzielania pierwszej pomocy.

The paper presents medico-legal problems associated with providing assistance to victims of traffic accidents. Legal acts have been analyzed in the aspect of help provision. Inconsistencies, and even divergences between individual regulations of the legal acts have been demonstrated. Particular attention has been paid to circumstances of providing emergency assistance, its scope, and situations when the obligation of providing first aid is no longer binding. The problem of provision or refusal to provide help seems--according to the authors--to be valid, since not all relevant legal regulations are generally known.