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ADDENDUM 3 - Reporting Standards for Assessing Outcomes

A. PREOPERATIVE EVALUATION

Patient comorbidities
  Medical: diabetes mellitus, peripheral artery disease, coronary artery disease, chronic
  obstructive pulmonary disease, end stage renal disease/chronic renal insufficiency, injuries, cancer
  Functional: mental, arthritis before amputation
Preoperative functional status
Healing prediction level method (pulmonary emboli, transcutaneous PO2, pressure, etc.)

B. CLASSIFICATION

Amputation should be classified with a combination of the following factors:

B.1. Etiology
B.2. Operative details
B.3. Type of anesthesia

C. OUTCOME CRITERIA

C.1. Perioperative (30 days):
  C.1.A. Systemic complications (mortality, cardiac, respiratory, infections, deep vein thrombosis, decubitus,
  pain/emotional)
  C.1.B. Local amputation site
    1.a Postoperative amputation management strategies:
      1.a.1. Soft gauze dressings
      1.a.2. Nonremovable rigid dressings without an immediate prosthetic attachment
      1.a.3. Nonremovable rigid dressings with an immediate postoperative prosthesis (IPOP)
      1.a.4. Removable rigid plaster dressings (RRD)
      1.a.5. Prefabricated postoperative devices
    1.b. Complications
      1.b.1. Failed healing
        1. Primary: heals without open areas, problems
        2. Secondary: small open areas that can be managed with dressing strategies and wound care. Additional
        surgery is not required. This can occasionally be the original plan when some portion of the amputation
         is left open.
        3. Requires minor surgical revision: skin and subcutaneous tissue (no muscle, no bone)
        4. Requires major surgical revision involving muscle and bone: but heals at initial amputation "level"; for
        example, a midlength transtibial amputation that is revised and eventually heals at a short transtibial level.
        5. Requires revision to a higher amputation level: for example, a transtibial amputation that must be revised to
        either a knee disarticulation or a transfemoral amputation.
      1.b.2. Hematoma observation/drainage
      1.b.3. Edema (discharge/residual limb volume)
      1.b.4. Contractions
      1.b.5. Residual limb infection
      1.b.6. Local nonamputation site
      1.b.7. Length of stay

C.2. Postamputation ( > 30 days)
  C.2.a. Systemic
  C.2.b. Contralateral limb
  C.2.c. Residual limb
  C.2.d. Prosthesis
  C.2.e. Rehabilitation
    1.c.1. Acute rehab
    1.c.2. Mode of rehab (outpatient/inpatient)
    1.c.3. Functional status (physician, physical therapist, etc.) input
    1.c.4. Ambulatory indoor, outdoor, nonambulatory
    1.c.5. Discharge destination
    1.c.6. Care facility
    1.c.7. Postrehabilitation care