Factors affecting wound healing after major amputation for vascular disease: a review.

Introduction There has been a continuous increase in the incidence of major lower limb amputations from the beginning of the century until the mid-1980s (Table 1). This increase has been attributed to the increasing number of elderly persons, diabetics and smokers (Liedberg and Persson, 1983). During the last decade, several reports from Scandinavia have mentioned a decreased incidence of major amputations (Larsson et al., 1995; Larsson and Risberg, 1988; Persson et al., 1989; Pohjolainen and Alaranta, 1988; Sernbo et al., 1996; Wahlberg et al., 1994). Others have reported a reduction in the number of major amputations (Ebskov et al., 1994; Eickhoff, 1993; Lindholt et al., 1994; Luther, 1994; Lääperi et al., 1993; Pedersen et al., 1994; Pell et al., 1994; Stenström et al., 1992). The reduction has been attributed to better foot care among diabetics (Gibbons et al., 1993; Larsson et al., 1995), and an increase and improvement in vascular surgery (Ebskov et al., 1994; Eickhoff, 1993; Giddings et al., 1993; Jeans et al.,