Factors Influencing Wound Healing of Critical Ischaemic Foot after Bypass Surgery: Is the Angiosome Important in Selecting Bypass Target Artery?
Factors Influencing Wound Healing of Critical Ischaemic Foot after Bypass Surgery: Is the Angiosome Important in Selecting Bypass Target Artery?
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DOI：
10.1016/j.ejvs.2011.12.001
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发表时间：
2012-03-01
影响因子：
5.7
通讯作者：
Sasajima, T.
中科院分区：
文献类型：
--
作者：
Azuma, N.;Uchida, H.;Sasajima, T.
目的：本研究的目的是确定影响缺血性伤口愈合的因素和血管体概念在旁路surgery.Design中的作用：单中心，回顾性临床研究.Materials and Methods：共249个连续的关键缺血性肢体组织损失228例接受远端旁路从2003年至2009年进行了审查。共有81%的患者患有糖尿病，49%的患者患有透析依赖性肾病（终末期肾病，ESRD）。转流的远端靶点为小腿动脉（57%）和足动脉（43%）。结果：211条肢体（84.7%）缺血性创面完全愈合。ESRD（比值比（OR）0.127，p < 0.001），糖尿病（OR 0.216，p = 0.030），Rutherford分类6（R6）伴足跟溃疡/坏疽（OR 0.134，p < 0.001）、除足跟外的R6（OR 0.336，p = 0.025）和低白蛋白血症（OR 0.387，p = 0.049）是伤口愈合的阴性预测因子。关于血管小体，间接血运重建（IR）组的愈合速度慢于直接血运重建（DR）组，尤其是ESRD患者（p
Objectives: The aim of the study is to determine factors affecting ischaemic wound healing and role of the angiosome concept in bypass surgery.Design: Single-centre, retrospective clinical study.Materials and methods: A total of 249 consecutive critical ischaemic limbs with tissue loss in 228 patients who underwent distal bypasses from 2003 to 2009 were reviewed. A total of 81% of patients were diabetic, and 49% of patients had dialysis-dependent renal disease (end-stage renal disease, ESRD). Distal targets of bypasses were the crural artery (57%) and the pedal artery (43%).Results: The complete healing of ischaemic wounds was achieved in 211 limbs (84.7%). ESRD (odds ratio (OR) 0.127, p < 0.001), diabetes (OR 0.216, p = 0.030), Rutherford category 6 (R6) with heel ulcer/gangrene (OR 0.134, p < 0.001), R6 except heel (OR 0.336, p = 0.025) and low albuminaemia (OR 0.387, p = 0.049) were negative predictors of wound healing. Regarding the angiosome, the healing rate in the indirect revascularisation (IR) group was slower than in the direct revascularisation (DR) group, especially in patients with ESRD (p