Skin graft or amputation (edema and arthritis comorbidities)?

Not exactly related, my dad had an extensive skin graft, skin taken from his thigh and placed on his head, in a skin cancer treatment. He has in his upper 80’s at the time with progressive CHF. The healing was horribly slow, both on the leg and head, taking most of a year. It never looked well in either place. In my dad’s case, I found the whole thing to be ill advised, as it would have taken more than 20 years to really cause his end. My dad walked a slow, shuffling walk his last years, with multiple falls, but his wasn’t only the ill advised surgery, CHF and its accompanying fluid overload was at work. Your dad is in a different position. I’d advise the best vascular specialist you can find, along with getting the most realistic prognosis about recovery. I wish you all the best in finding the best plan

I know that you understand that no matter our histories, we none of us are qualified as doctors to advise you. Even were we doctors, we do not know this patient, and that is CRUCIAL. I am an OLD RN, long retired, more than two decades, so I want you first to understand that ANYTHING I say here is to be taken with a grain of salt. Your best advice now comes from doctors. Ask for specialists. You are dealing with someone with vascular insufficieny of the lower extremities and with edema that may be indicative of some modicum of heart failure. There has already been a DVT, and these are DEADLY when thrown to the lungs. This is a very ill man and WHATEVER choice is now made, I know the doctors will inform you, will mean that outcome is touch and go, perhaps for the rest of his life.

You do not mention under co-morbidities any diabetes.
I hope that is the case, for I would be truly worried to hear that added onto these problems.

Again, this is touch and go stuff and you want the opinions of a GOOD VASCULAR specialist, a good and thorough heart exam with testing, and to know conditions of lungs, and etc. You already will know that there is a danger to anesthesia due to age and due to condition. An amputation MAY be longer duration than skin grafting and with need for longer and more potent sedation. A lumpectomy was recently recommended for my cancer rather than a mastectomy simply because I am 81 and the difference in a 1 1/2 hour versus a 4 hour surgery can mean a lot for outcome without any danger of dementia due to anesthesia.

I am trying to give you all the things that need to be considered here, and the next thing for consideration, other than your loved one OWN WISHES is what amputation means. Often they do not heal. Especially in aged. As an RN I often saw amputation patients many times due to their need for revision of stump, due to non-healing and infection, and often for further, higher amputation.
Skin grafts in this area will be difficult to heal if there is not wound care specialist followup. That may mean SNF for some months. That means painful dressings. That means that any edema could ruin the grafting no matter the care taken.

I am sorry to lay all the bad news upon you but people do fail to know that the sloughing of skin due to edema can have terrible consequences. You are there now, and likely this could not have been prevented even with diuretics and good elevation of limbs. But it is tough now and I must tell you to make the best decisions you can after having doctors DISCUSS ALL OF THE RISKS with you. If they don't have time to talk with you at length then you need another opinion, as this is a must.

I am so sorry you are facing this down.
I hope you will update us on your decision.
I hope I haven't scared you too badly and I just want you to know all that COULD BE involved here. I truly do wish you the very best of luck.