IMPROVED WOUND-HEALING IN TRANSTIBIAL AMPUTEES RECEIVING SUPPLEMENTARY NUTRITION

The objective of this prospective study of matched controls was to fin d out whether supplementary nutrition would improve wound healing and decrease mortality in patients undergoing transtibial amputation for o cclusive arterial disease. The nutritional status of 32 consecutive tr anstibial amputees was assessed and 28 were classified as malnourished . Supplementary nutrition was given reaching an average intake of 2098 kcal/day for a total of II days. In 24 patients, at least 5 days preo perative supplementary nutrition were given, followed by postoperative treatment for a total of II days. Four patients who had an immediate operation were given only postoperative treatment, and 4 were excluded The controls were 32 amputees in another hospital and matching proced ures were carried out with corrections for diabetes, sex, age, smoking habits, previous vascular surgery and living conditions before amputa tion. Healing, including those healed before death in both groups, occ urred in 26 of the nutrition group compared to 13 in the control group , which was statistically significant. Nine patients died within 6 mon ths in the nutrition group compared to 14 of the controls (not signifi cant). Malnutrition was present in nearly 90% of transtibial amputees and supplementary nutrition improved healing, but not mortality.