surgical site infection

Surgical Site Infections in Major Lower Limb Amputation – Transmetatarsal Extension (SIMBA-T): an international multicentre audit: study protocol

October 29, 2025

Introduction Background and rationale In patients with chronic limb threatening ischaemia (CLTI) or diabetes related foot complications, transmetatarsal amputation (TMA) is often required to treat serious infection or remove gangrenous digits to promote a healing wound. This is often accompanied by an attempt at revascularisation of the limb. TMA preserves limb length as well…

Surgical Site Infection in Major Lower Limb Amputation (SIMBA): an international multicentre audit: baseline unit survey

August 18, 2025

Introduction Surgical site infections (SSIs) are a common complication following any surgical procedure, accounting for 20% of all hospital-associated infections.1 The incidence of SSI following major lower limb amputation (MLLA) is particularly high, with a recent systematic review reporting an overall incidence of 7.2% and single-centre studies reporting rates up to 27%.2 SSIs are a…

The incidence of surgical site infection following transmetatarsal amputation: a systematic review

August 18, 2024

Introduction Transmetatarsal amputations (TMAs) were first popularised in 1949 by McKittrick et al, who used this procedure as an alternative to more proximal amputations when addressing gangrene or infection.1 Its use has continued as an effective surgical approach in treating forefoot gangrene, infection and chronic ulceration, most commonly in patients with diabetic foot or vascular…

Surgical Site Infections in Major Lower Limb Amputation: An International Multicentre Audit (SIMBA): Study Protocol

February 29, 2024

Introduction Background and rationale Surgical site infection (SSI) is a significant potential complication of any surgical procedure, acknowledged by the National Institute of Health and Care Excellence (NICE) as a leading cause of in-hospital morbidity and mortality.1 In vascular surgery, patients undergoing major lower limb amputation (MLLA) may be at an increased risk of developing…

A feasibility survey to inform trial design investigating surgical site infection prevention in vascular surgery

February 29, 2024

Introduction Surgical site infection (SSI) is common following vascular surgery, complicating up to 40% of groin incisions and major lower limb amputations (MLLA).1–3 SSI significantly impairs quality of life due to associated pain, reduced mobility, depression and anxiety.4 SSI results in a fourfold increase in the risk of readmission and substantially increases healthcare costs, estimated…