PMID- 35105193
OWN - NLM
STAT- MEDLINE
DCOM- 20230320
LR  - 20230320
IS  - 1708-539X (Electronic)
IS  - 1708-5381 (Linking)
VI  - 31
IP  - 2
DP  - 2023 Apr
TI  - Predictors of delayed wound healing after simultaneous endovascular treatment and 
      minor forefoot amputation for chronic limb-threatening ischemia with wound 
      infection.
PG  - 333-340
LID - 10.1177/17085381211067601 [doi]
AB  - OBJECTIVES: To assess wound healing after simultaneous endovascular treatment 
      (EVT) and minor forefoot amputation and identify the predictors of delayed wound 
      healing in patients with chronic limb-threatening ischemia (CLTI) and bacterial 
      infections of the wounds. METHODS: In this single-center retrospective cohort 
      study, we evaluated 79 consecutive limbs with tissue loss from 73 CLTI patients 
      who underwent simultaneous EVT and minor forefoot amputation between November 
      2017 and May 2020. To estimate the rate of wound healing after the simultaneous 
      procedure, we used the Kaplan-Meier method. To assess the association between 
      baseline characteristics and delayed wound healing, we used the Cox proportional 
      hazard model. RESULTS: All patients who underwent the simultaneous procedure had 
      ischemic wounds with bacterial infection. The rate of wound healing at 6 months 
      reached 82%. The median time for wound healing was 76 days. According to 
      multivariable analysis, Lisfranc/Chopart amputation (hazard ratio (HR) 2.46, 95% 
      confidence interval (CI) 1.09-6.60), absence of above-the-knee (ATK) occlusive 
      lesions (HR 1.89, 95% CI 1.04-3.45), and poor below-the-ankle (BTA) runoff (HR 
      1.77, 95% CI 1.01-3.11) were independent predictors of delayed wound healing. 
      CONCLUSION: Lisfranc/Chopart amputation, absence of ATK occlusive lesions, and 
      poor BTA runoff were independent predictors of delayed wound healing after 
      simultaneous EVT and minor forefoot amputation in patients with CLTI and 
      bacterial infections of the wound.
FAU - Yanagiuchi, Takashi
AU  - Yanagiuchi T
AUID- ORCID: 0000-0001-5179-1277
AD  - Department of Cardiology, 13684Rakuwakai Otowa Hospital, Kyoto, Japan.
FAU - Kato, Taku
AU  - Kato T
AD  - Department of Cardiology, 13684Rakuwakai Otowa Hospital, Kyoto, Japan.
FAU - Hirano, Keita
AU  - Hirano K
AD  - Department of Nephrology, 38049Kyoto University Graduate School of Medicine, 
      Kyoto, Japan.
FAU - Toki, Hiroyuki
AU  - Toki H
AD  - Department of Plastic and Reconstructive Surgery, 13684Rakuwakai Otowa Hospital, 
      Kyoto, Japan.
FAU - Imura, Haruki
AU  - Imura H
AD  - Department of Infectious Diseases, 13684Rakuwakai Otowa Hospital, Kyoto, Japan.
FAU - Matsubara, Kunihiko
AU  - Matsubara K
AD  - Department of Dermatology, 13684Rakuwakai Otowa Kinen Hospital, Kyoto, Japan.
FAU - Ushimaru, Shunpei
AU  - Ushimaru S
AD  - Department of Cardiology, 13684Rakuwakai Otowa Hospital, Kyoto, Japan.
FAU - Yokoi, Hirokazu
AU  - Yokoi H
AD  - Department of Cardiology, 13684Rakuwakai Otowa Hospital, Kyoto, Japan.
FAU - Zen, Kan
AU  - Zen K
AD  - Department of Cardiovascular Medicine, 12898Kyoto Prefectural University of 
      Medicine, Kyoto, Japan.
FAU - Matoba, Satoaki
AU  - Matoba S
AD  - Department of Cardiovascular Medicine, 12898Kyoto Prefectural University of 
      Medicine, Kyoto, Japan.
LA  - eng
PT  - Journal Article
DEP - 20220201
PL  - England
TA  - Vascular
JT  - Vascular
JID - 101196722
SB  - IM
MH  - Humans
MH  - Chronic Limb-Threatening Ischemia
MH  - Treatment Outcome
MH  - Risk Factors
MH  - Retrospective Studies
MH  - *Peripheral Arterial Disease/diagnostic imaging/surgery
MH  - Limb Salvage
MH  - Amputation, Surgical
MH  - Ischemia/diagnostic imaging/surgery
MH  - *Endovascular Procedures/adverse effects
MH  - Wound Healing
MH  - *Wound Infection
OTO - NOTNLM
OT  - Chronic limb-threatening ischemia
OT  - critical limb ischemia
OT  - endovascular treatment
OT  - minor forefoot amputation
OT  - wound bacterial infection
OT  - wound healing
EDAT- 2022/02/03 06:00
MHDA- 2023/03/21 06:00
CRDT- 2022/02/02 05:28
PHST- 2022/02/03 06:00 [pubmed]
PHST- 2023/03/21 06:00 [medline]
PHST- 2022/02/02 05:28 [entrez]
AID - 10.1177/17085381211067601 [doi]
PST - ppublish
SO  - Vascular. 2023 Apr;31(2):333-340. doi: 10.1177/17085381211067601. Epub 2022 Feb 
      1.