An analysis of risk factors associated with traumatic extremity amputation stump wound infection in a Nigerian setting

We aimed to determine the risk factors associated with traumatic extremity amputation stump wound infection in our environment. This was a retrospective analysis of databases that included the entire patient population with traumatic extremity amputation seen in Ebonyi State University Teaching Hospital and Federal Medical Centre Abakaliki from January 2001 to December 2011. There were 63 patients studied and stump wound infection was a complication in 38 (60 %) of them. Stump wound infection rate significantly correlated with the form of amputation, i.e., a higher rate in crushing than guillotine (sharp clear-cut) amputation (80.5 vs. 22.7 % p < 0.000); severity, i.e., a higher rate in major than minor amputation (80.6 vs. 33.3 % p < 0.000); and limb involvement, i.e., a higher rate in lower than upper extremity amputation (71.1 vs. 60.7 % p < 0.002). Haematocrit level on admission (p < 0.002), injury to hospital admission interval (p < 0.012) and injury to first surgical debridement / amputation interval (p < 0.02) were all significantly related to incidence of wound infection. Multivariate analysis identified crushing amputation as an independent risk factor (p < 0.009) for traumatic amputation stump wound infection. The only independent predictor of traumatic extremity amputation stump wound infection is a crushing form of amputation; it should be accorded a high priority in interventions aimed at reducing infection rate.