| The influence of the characteristics of ischemic tissue lesions on ulcer healing time after infrainguinal bypass for critical leg ischemia. | |
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MedLine Citation:
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PMID: 19223145 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Ulcer healing is a seldom reported outcome in studies of critical leg ischemia (CLI). The aim of this study was to analyze local factors affecting ulcer healing time after infrainguinal bypass surgery (IBS) for CLI Fontaine IV. METHODS: In this prospective single center cohort study, 110 patients (113 legs) undergoing IBS due to CLI with ischemic tissue defects during year 2006 were followed prospectively for 1 year after the bypass. Ulcer location, duration, presence of gangrene, and the University of Texas wound classification (UTWCS) were determined at presentation. Healing time of the ischemic tissue defects, leg salvage, patency, and survival were calculated. The characteristics of the ischemic tissue lesions and patient comorbidities were analyzed to determine risk factors for adverse outcome. RESULTS: Complete ulcer healing (+/-SE) was achieved in 74% +/- 5% of the legs 12 months after IBS. Median ulcer healing time was 186 days (range, 11 to >365 days). Leg salvage, secondary patency, and survival at 12 months were 87% +/- 3%, 82% +/- 4%, and 76% +/- 5%, respectively. Amputation-free survival with healed ulcers was attained in 55% at 12 months. Ischemic tissue lesions located in the mid- and hindfoot had significantly prolonged ulcer healing time (hazard ratio [HR] 0.4, 95% confidence interval [CI] 0.1 to 0.9, P = .044). None of the UTWCS classes predicted either ulcer healing time or leg salvage. Median ulcer duration before IBS was 68 days, range, 6 to 1154 days. Ulcer duration did not correlate with ulcer healing time (Spearman r = 0.138, P = .267). Ischemic ulcers with gangrene were not associated with prolonged ulcer healing time (P = .353). CONCLUSION: The location of the ischemic tissue lesions influences ulcer healing time. According to our study UTWCS can be used as descriptive classification of ischemic ulcers but it does not predict the ulcer healing time or leg salvage after infrainguinal bypass surgery. |
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Authors:
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Maria Söderström; Pekka-Sakari Aho; Mauri Lepäntalo; Anders Albäck |
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Publication Detail:
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Type: Journal Article Date: 2009-02-15 |
Journal Detail:
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Title: Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter Volume: 49 ISSN: 1097-6809 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-04-03 Completed Date: 2009-04-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 932-7 Citation Subset: IM |
Affiliation:
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Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Amputation Blood Vessel Prosthesis Implantation* Critical Illness Female Follow-Up Studies Gangrene Humans Ischemia / complications, pathology, physiopathology, surgery* Leg Ulcer / etiology, pathology, physiopathology, surgery* Limb Salvage Lower Extremity / blood supply* Male Middle Aged Prospective Studies Reoperation Severity of Illness Index Time Factors Treatment Outcome Vascular Patency Veins / transplantation* Wound Healing* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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