Symposium topic
The European Society for Vascular Surgery (ESVS) has developed clinical practice guidelines for adults undergoing major limb amputation, based on the latest scientific results. While most amputations are related to peripheral arterial disease and diabetes, the guidelines also address trauma and cancer.
This symposium will explore how these guidelines support a structured, patient-centred approach to amputation care, from pre-operative decision making through surgery and into early rehabilitation. Key topics include shared decision making, amputation level selection, surgical techniques, pain management, post-operative care, and early rehabilitation.
Emphasis will be placed on integrating surgical, rehabilitation, and prosthetic perspectives to ensure continuity of care and improved outcomes. The session will also address challenges in implementing guideline-based care across different healthcare systems, including resource-limited and conflict-affected settings.
Underpinning science and theory
The symposium is grounded in a systematic review of the literature conducted according to the ESVS methodology. Recommendations are based on graded evidence and expert consensus, reflecting current best practice. The framework integrates clinical evidence, surgical principles, rehabilitation science, prosthetic and orthotic perspectives, and patient-centred care models within a multidisciplinary review process involving vascular surgeons, orthopaedic surgeons, rehabilitation physicians, physiotherapists, nurses, prosthetists/orthotists, and other rehabilitation professionals. It also acknowledges existing gaps in high-level evidence and highlights the need for further multidisciplinary research and collaboration.
Relevance for the ISPO World Congress
This symposium aligns with the congress theme by linking surgical decision making with rehabilitation and prosthetic care. It highlights the importance of interdisciplinary collaboration and guideline-based practice to improve outcomes, reduce variability, and promote equitable amputation care globally.
Perspectives
The symposium brings together multidisciplinary perspectives, including vascular surgeons, orthopaedic surgeons, rehabilitation physicians, physiotherapists, nurses, prosthetists/orthotists, and other rehabilitation professionals Each presenter will address different stages of the amputation pathway, highlighting the importance of coordinated, patient-centred care.
Learning objectives
At the end of this symposium, participants will:
• Understand the key recommendations from the ESVS clinical practice guidelines for limb amputation
• Describe how surgical decision making, including level selection, influences rehabilitation and prosthetic outcomes
• Recognise the importance of interdisciplinary collaboration
• Identify strategies to implement guideline-based care in different healthcare settings
• Reflect on current gaps in evidence and opportunities for future research and innovation in amputation care
