Use of Integra Dermal Regeneration Template for Limb Salvage in Diabetic Patients With No-Option Critical Limb Ischemia
| Autor: | Anna Carone, Luca Dalla Paola, Paolo Cimaglia, Giuseppe Scavone, Giulio Boscarino |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Time Factors Critical Illness medicine.medical_treatment 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Revascularization Amputation Surgical 03 medical and health sciences 0302 clinical medicine Ischemia Diabetes Mellitus medicine Clinical endpoint Humans Retrospective Studies Wound Healing business.industry Regeneration (biology) Retrospective cohort study General Medicine Critical limb ischemia Limb Salvage medicine.disease Diabetic Foot Surgery body regions Treatment Outcome Diabetic foot ulcer Amputation medicine.symptom Wound healing business |
| Zdroj: | The International Journal of Lower Extremity Wounds. 20:128-134 |
| ISSN: | 1552-6941 1534-7346 |
| DOI: | 10.1177/1534734620905741 |
| Popis: | We have analyzed in a retrospective study of consecutive diabetic patients affected by no-option critical limb ischemia (CLI) the efficacy of the dermal substitute Integra Dermal Regeneration Template for treatment of complicated foot lesions. The primary end point was limb salvage and 1-year amputation-free survival. The secondary end point was healing time of surgical site. Between October 2014 and October 2017, 1024 patients with diabetic foot ulcer (DFU) and CLI were admitted. In 84 patients (8.2%), there was a failure in distal revascularization with a persistent CLI after the procedure. Despite the persistent CLI, a group of 26 patients of this cohort obtained complete wound healing. Among them, 13 patients were treated with surgical debridement or open amputations and application of dermal substitute Integra Dermal Regeneration Template and the other 13 patients were treated without any dermal substitute. The Integra group healed within a mean time of 83.5 days, and the control group healed within a mean of 139 days ( P = .028). No major amputation was carried out at 1-year follow-up in the Integra group versus 15% in the control group. A conservative foot surgery or an approach with minor amputation in diabetic patients with no-option CLI may achieve limb salvage. The use of Integra Dermal Regeneration Template in patients with DFU and no-option CLI may be a useful option in a limb salvage program. |
| Databáze: | OpenAIRE |
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