Combined Reconstruction of the Diabetic Foot Including Revascularization and Free-Tissue Transfer
| Autor: | N. Verhelle, Xavier P Nelissen, O. Heymans, H. Vandamme, V Lemaire |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Free flap Revascularization Amputation Surgical Surgical Flaps Cohort Studies Ischemia Recurrence Blood vessel prosthesis Diabetes mellitus medicine Humans Surgical Wound Infection Popliteal Artery Muscle Skeletal Aged Foot Vascular disease business.industry Graft Survival Middle Aged medicine.disease Diabetic foot Diabetic Foot Blood Vessel Prosthesis Surgery Femoral Artery Treatment Outcome Debridement Amputation Female Complication business Diabetic Angiopathies Follow-Up Studies |
| Zdroj: | Journal of Reconstructive Microsurgery. 20:511-517 |
| ISSN: | 1098-8947 0743-684X |
| DOI: | 10.1055/s-2004-836121 |
| Popis: | Diabetic patients, presenting with both peripheral vascular disease and large soft-tissue defects, are too often treated by primary amputation. A combined revascularization and free-tissue transfer procedure can extend limb salvage in these patients. The authors report their experience over 4 years with 19 diabetic patients with peripheral vascular disease and large soft-tissue defects of the foot requiring free-tissue transfer. Although there was a 100 percent flap survival, early local wound problems occurred in three patients (16.6 percent). The recurrence rate was about 18.7 percent, but no complementary flap procedures were mandatory. With a mean follow-up of 38 months (range: 23 to 55 months), the limb salvage rate was 94.4 percent. Although there was one limb loss and one patient with ambulation difficulties, 16 patients (84.2 percent) were fully rehabilitated and were able to function independently. Despite a rather small series, this study confirms that in selected diabetic patients, a combined approach of vascular and reconstructive surgeons can reduce the limb amputation rate with acceptable complication rates. This combined approach offers major benefits to these patients, especially stable coverage and preservation of ambulation, and should always be considered before amputation. |
| Databáze: | OpenAIRE |
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