| Successful conservative therapy of severe limb-threatening ischemia: the value of nonsympathectomy. | |
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MedLine Citation:
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PMID: 3715719 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Fourteen patients with severely ischemic extremities but relatively minor degrees of pedal gangrene or ulceration were managed without surgery. Contraindications to direct arterial reconstruction included significant intercurrent illness or generally poor surgical risk, the need for reoperative or difficult distal reconstruction, or the favorable characteristics of the actual lesion. Management consisted of bed rest, simple saline soaks, occasional gentle debridement, and antibiotics when indicated. Seven patients had complete resolution of their lesions for 3 to 48 months, and seven had improvement or stabilization for 3 to 18 months. Only three of the 14 patients have eventually required surgery with limb salvage in one. Revascularization remains the method of choice for managing most severely ischemic extremities. However, the conservative approach described represents an alternative to early amputation, attempts at revascularization, or lumbar sympathectomy in some patients with advanced ischemia. Studies of sympathectomy and pharmacologic agents as effective treatment for ischemic ulcers or gangrene should include control groups treated with the conservative measures outlined herein. |
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Authors:
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S P Rivers; F J Veith; E Ascer; S K Gupta |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Surgery Volume: 99 ISSN: 0039-6060 ISO Abbreviation: Surgery Publication Date: 1986 Jun |
Date Detail:
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Created Date: 1986-06-27 Completed Date: 1986-06-27 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0417347 Medline TA: Surgery Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 759-62 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Amputation Anti-Bacterial Agents / therapeutic use Bed Rest Follow-Up Studies Gangrene / therapy Hospitalization Humans Ischemia / etiology, therapy* Leg / blood supply* Leg Ulcer / therapy Length of Stay Middle Aged Sympathectomy* Vascular Surgical Procedures |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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