PMID- 35860822
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220722
IS  - 1881-641X (Print)
IS  - 1881-6428 (Electronic)
IS  - 1881-641X (Linking)
VI  - 15
IP  - 2
DP  - 2022 Jun 25
TI  - Efficacy of Early Closed Toe Amputation for Toe Ulcers with Suspected 
      Osteomyelitis after Revascularization for Chronic Limb-Threatening Ischemia.
PG  - 126-133
LID - 10.3400/avd.oa.21-00136 [doi]
AB  - Objective: In this study, we aim to evaluate the efficacy of early closed toe 
      amputation on the wound management of toe ulcers with suspected osteomyelitis 
      after revascularization for chronic limb-threatening ischemia (CLTI). Methods: 
      This retrospective study included patients who have underwent revascularization 
      for toe ulcers associated with CLTI at Shizuoka Red Cross Hospital from 2015 to 
      2021. Wound management comprised early closed toe amputation for toe ulcers with 
      suspected osteomyelitis (19 toes in 17 patients) or conservative treatment (35 
      toes in 26 patients). The primary endpoint was wound healing after 
      revascularization. We compared the wound healing rate at 90 days and median 
      healing time of early closed toe amputation versus conservative treatment. 
      Results: Compared with the conservative treatment, early closed toe amputation 
      was able to achieve a better wound healing rate at 90 days (89.5% vs. 68.6%; 
      P<0.01) and a shorter median healing time (19 days vs. 62 days; P=0.01). 
      Conclusion: There remains no established wound management for toe lesions 
      associated with CLTI. Despite its several disadvantages including wound infection 
      and possible foot deformity, early closed toe amputation for toe ulcers with 
      suspected osteomyelitis can be considered a safe approach in terms of wound 
      management.
CI  - (c) 2022 The Editorial Committee of Annals of Vascular Diseases.
FAU - Shintani, Tsunehiro
AU  - Shintani T
AD  - Department of Vascular Surgery, Shizuoka Red Cross Hospital, Shizuoka, Shizuoka, 
      Japan.
FAU - Suzuki, Sachi
AU  - Suzuki S
AD  - Department of Plastic and Reconstructive Surgery, Shizuoka Red Cross Hospital, 
      Shizuoka, Shizuoka, Japan.
FAU - Kikuchi, Naoya
AU  - Kikuchi N
AD  - Department of Vascular Surgery, Shizuoka Red Cross Hospital, Shizuoka, Shizuoka, 
      Japan.
FAU - Ariya, Takumi
AU  - Ariya T
AD  - Department of Vascular Surgery, Shizuoka Red Cross Hospital, Shizuoka, Shizuoka, 
      Japan.
FAU - Natsume, Kayoko
AU  - Natsume K
AD  - Department of Vascular Surgery, Shizuoka Red Cross Hospital, Shizuoka, Shizuoka, 
      Japan.
FAU - Ookura, Kazuhiro
AU  - Ookura K
AD  - Department of Cardiac Surgery, Shizuoka Red Cross Hospital, Shizuoka, Shizuoka, 
      Japan.
FAU - Okui, Jun
AU  - Okui J
AD  - Department of Preventive Medicine and Public Health, Keio University School of 
      Medicine, Tokyo, Japan.
FAU - Sato, Yasunori
AU  - Sato Y
AD  - Department of Preventive Medicine and Public Health, Keio University School of 
      Medicine, Tokyo, Japan.
FAU - Obara, Hideaki
AU  - Obara H
AD  - Department of Surgery, Keio University School of Medicine,Tokyo, Japan.
LA  - eng
PT  - Journal Article
PL  - Japan
TA  - Ann Vasc Dis
JT  - Annals of vascular diseases
JID - 101471467
PMC - PMC9257390
OTO - NOTNLM
OT  - chronic limb-threatening ischemia
OT  - toe amputation
OT  - toe ulcer
COIS- Disclosure StatementAll authors declare no conflict of interest.
EDAT- 2022/07/22 06:00
MHDA- 2022/07/22 06:01
PMCR- 2022/06/25
CRDT- 2022/07/21 02:39
PHST- 2021/11/18 00:00 [received]
PHST- 2022/04/26 00:00 [accepted]
PHST- 2022/07/21 02:39 [entrez]
PHST- 2022/07/22 06:00 [pubmed]
PHST- 2022/07/22 06:01 [medline]
PHST- 2022/06/25 00:00 [pmc-release]
AID - 10.3400/avd.oa.21-00136 [doi]
PST - ppublish
SO  - Ann Vasc Dis. 2022 Jun 25;15(2):126-133. doi: 10.3400/avd.oa.21-00136.