A case of lower-extremity amputation in a hemophiliac patient is presented and the literature is reviewed with specific analysis of twelve cases in which there was infection on potential infection in the stump. It is pointed out that most hemophiliac patients who require amputation have infection or potential infection. In every case reported primary closure of the amputation stump was performed. Postoperative infection and bleeding occurred in most cases. Significant delay in wound healing for from three to six months, with as much as twelve months required for complete healing in some cases, was the rule.
It is suggested that with Factor VIII available the basic surgical principle of open amputation in the presence of infection on potential infection should be applied to hemophiliac patients as it is to normal patients in order to prevent the catastrophic results which have been reported to date.
Jefferson Medical College, Thomas Jefferson University Hospital, 11th and Walnut Streets, Philadelphia, Pennsylvania 19107