{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:37:34Z","timestamp":1785908254919,"version":"3.56.0"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T00:00:00Z","timestamp":1576800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Lower limb crush injury is a major source of mortality and morbidity in trauma patients. Complications, especially surgical site infections (SSIs) are a major source of financial burden to the institute and to the patient as it delays rehabilitation. As such, every possible attempt should be made to reduce any complications. We, thus, aimed to compare the outcomes in early vs delayed closure of lower extremity stumps in cases of lower limb crush injury requiring amputation, so as to achieve best possible outcome. A randomised controlled study was conducted in the Division of Trauma Surgery &amp; Critical Care at Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi from 1 September 2018 to 30 June 2019 and included patients undergoing lower limb amputation below hip joint. Patients were randomised in two groups, in one group amputation stump was closed primarily, while in the second group delayed primary closure of stump was performed. We compared rate of SSI, length of hospital stay, and number of surgeries in both the groups. Fifty\u2010six patients with 63 amputation stumps were recruited in the study. Mean age of patients in the study was 34\u2009years, of which about 95% patients were males. The most common mechanism of injury was road traffic injury in 66% of patients. Mean injury severity score was 12.28 and four patients had diabetes preoperatively. Total 63 extremities were randomised with 30 cases in group I and 33 cases in group II as per computer\u2010generated random number. Above knee amputations was commonest (57.14%) followed by below knee amputations (33.3%). Two patients died in the current study. In group I, In\u2010hospital infection was detected in 7 cases (23.3%) and in group II 9 cases (27.3%) had SSI during hospital admission (<jats:italic>P<\/jats:italic>\u2009&gt;\u2009.05). Mean hospital stay in group I was 10.32 \u00b1\u20097.68\u2009days and in group II was 11 \u00b1\u20098.17\u2009days (<jats:italic>P<\/jats:italic>\u2009&gt;\u2009.05). Road traffic injuries and train\u2010associated injuries are a major cause of lower limb crush injuries, leading to limb loss. Delayed primary closure of such wounds requires extra number of surgical interventions than primary closure. There is no difference in extra number of surgical interventions required in both the groups. Thus, primary closure can be safely performed in patients undergoing lower limb amputations following trauma, provided that a good lavage and wound debridement is performed.<\/jats:p>","DOI":"10.1111\/iwj.13288","type":"journal-article","created":{"date-parts":[[2019,12,21]],"date-time":"2019-12-21T00:24:28Z","timestamp":1576887868000},"page":"419-428","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Primary vs delayed primary closure in patients undergoing lower limb amputation following trauma: A randomised control study"],"prefix":"10.1111","volume":"17","author":[{"given":"Anand K.","family":"Katiyar","sequence":"first","affiliation":[{"name":"Division of Trauma Surgery &amp; Critical Care, JPNATC AIIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harshit","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Division of Trauma Surgery &amp; Critical Care, JPNATC AIIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratyusha","family":"Priyadarshini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhinav","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subodh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Trauma Surgery &amp; Critical Care, JPNATC AIIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Trauma Surgery &amp; Critical Care, JPNATC AIIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biplab","family":"Mishra","sequence":"additional","affiliation":[{"name":"Division of Trauma Surgery &amp; Critical Care, JPNATC AIIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richa","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Critical and Intensive care, JPNATC AIIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kapil D.","family":"Soni","sequence":"additional","affiliation":[{"name":"Department of Critical and Intensive care, JPNATC AIIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Purva","family":"Mathur","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, JPNATC AIIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Sagar","sequence":"additional","affiliation":[{"name":"Department of Psychiatry AIIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anurag","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Surgical Disciplines AIIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niladri","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Division of Trauma Surgery &amp; Critical Care, JPNATC AIIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushma","family":"Sagar","sequence":"additional","affiliation":[{"name":"Division of Trauma Surgery &amp; Critical Care, JPNATC AIIMS  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.18639\/RABM.2018.04.729264"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.013115"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2016.11.019"},{"issue":"3","key":"e_1_2_7_5_1","first-page":"16","article-title":"Incidence and causes of lower\u2010limb amputations in a tertiary care center: evaluation of the medical records in a period of 2\u2009years","volume":"2","author":"Kumar GK","year":"2018","journal-title":"Int J Surg"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199910000-00018"},{"issue":"2","key":"e_1_2_7_7_1","first-page":"77","article-title":"Current trends of major lower limb amputations at a tertiary care centre of Jammu, India","volume":"2","author":"Maqsood M","year":"2015","journal-title":"Int J Med Sci Res Pract"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268800051712"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/10962960260496325"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2007.030"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002464"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hkpj.2012.12.002"},{"key":"e_1_2_7_13_1","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1097\/00003086-199007000-00013","article-title":"Limb salvage versus amputation. Preliminary results of the mangled extremity severity score","volume":"256","author":"Helfet DL","year":"1990","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001339"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2004.06.017"},{"issue":"1","key":"e_1_2_7_16_1","first-page":"51","article-title":"Mangled lower extremity: can we trust the amputation scores?","volume":"2","author":"Fodor L","year":"2012","journal-title":"Int J Burns Trauma"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-015-0832-7"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.12816\/0047632"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199301000-00018"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2017.06.144"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(88)90106-1"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2016.12.019"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002640050186"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fiwj.13288","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.13288","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/iwj.13288","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.13288","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T03:23:09Z","timestamp":1744860189000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.13288"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,20]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1111\/iwj.13288"],"URL":"https:\/\/doi.org\/10.1111\/iwj.13288","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,20]]},"assertion":[{"value":"2019-10-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}