Prisma in minor amputations

A randomised control trial designed to test the hypothesis: 1. Promogran Prisma provides improved wound healing in patients who undergo minor amputation of the lower limb. Promogran Prisma is a matrix topical wound dressing composed of 55% bovine derived collagen, 44% oxidised regenerated cellulose (ORC) and 1% silver ORC. Patients will be randomised using a pre-randomised secret envelope system containing random assignment to either control or trial group, available at the time of lower limb minor amputation: A trial group who will receive Promogran Prisma ™ as primary dressing, placed into the wound bed post completion of minor amputation, The Promogran Prisma ™ will be covered with absorbent secondary dressings and secured with crepe bandage. The dressing will be reviewed at the 48 hour mark unless otherwise indicated. The patient will continue to use Promogran Prisma ™ as the primary wound dressing and will remain the only variable to standard minor amputation post-operative wound management for a period of 12 weeks. This group will be used to assess the effect of Promogran Prisma™ as a primary wound dressing for minor amputations. Dressings will be applied by the governing surgical team intraoperatively, and then by hospital and community nursing staff post initial intraoperative placement. This follows the current usual standard of care.