FOREFOOT GANGRENE AND DISTAL BYPASS - 2-S TAGED AMPUTATION

When revascularizing for gangrene, deciding on amputation depends on t he risk of infection due to trophic injury both for the foot and for t he bypass and on the requirement to attempt amputation at the correct level at the first operation. In our experience, the importance of inf ection has led us to propose the following sequence: if the lesions ar e infected - immediate amputation, differed revascularization after th e infection has been controlled : if the lesions are dry early vascula rization followed by amputation either during the same operation with strict separation of the two operative fields or a few days later, par ticularly if the level of the amputation has been determined.