SS12 Prospective Analysis of Wound Characteristics and Degree of Ischemia on Time to Wound Healing and Limb Salvage: An Early Validation of the Society for Vascular Surgery Lower Extremity Threatened Limb Classification System
| Autor: | Brent L. Johnson, Ginger Manos, John F. Eidt, Spence M. Taylor, Michael C. Hartley, David L. Cull, Eugene M. Langan |
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| Jazyk: | angličtina |
| Předmět: |
medicine.medical_specialty
integumentary system business.industry Limb salvage medicine.medical_treatment Ischemia Critical limb ischemia Vascular surgery medicine.disease Revascularization Surgery Diabetes mellitus medicine medicine.symptom Cardiology and Cardiovascular Medicine Wound healing business Survival analysis |
| Zdroj: | Journal of Vascular Surgery. (6):28S |
| ISSN: | 0741-5214 |
| DOI: | 10.1016/j.jvs.2014.03.067 |
| Popis: | Objectives: The Society for Vascular Surgery (SVS) recently established the Lower Extremity Threatened Limb Classification System, a staging system using Wound characteristic/Ischemia/foot Infection (WIfI) to stratify the risk of limb amputation at 1 year. Although intuitive in nature, the new system has not been validated. The purpose of this study was to determine whether the WIfI system is predictive of limb loss/wound healing. Methods: Between 2008 and 2010, we prospectively scored 139 patients with foot wounds (158 revascularizations) at the time of the revascularization procedure using a novel wound classification grading system similar to WIfI. The ischemic component of the grading system was obtained immediately postprocedure. Adapting our data to the WIfI classification, the influence of grading system factors on time to wound healing was analyzed. Empirical Kaplan-Meier survival curves were compared with theoretical outcomes predicted by WIfI expert consensus opinion. Results: Seventy-nine percent (125 of 158) of the foot wounds healed. The median time to wound healing was 4 months (range, 1-18 months). Factors associated with wound healing included presence of diabetes mellitus (P 1⁄4 .013), wound location (P 1⁄4 .049), wound size (P 1⁄4 .007), wound depth (P 1⁄4 .004), and degree of ischemia (P < .001). A comparison of observed vs theoretical outcomes is shown in the Table. Conclusions: The theoretical framework for risk stratification among patients with critical limb ischemia provided by |
| Databáze: | OpenAIRE |
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